Individual
ANITA PETTEWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 NW 168TH ST STE 301, NORTH MIAMI BEACH, FL 33169-6051
(305) 944-8887
(877) 488-9590
Mailing address
150 NW 168TH ST STE 301, NORTH MIAMI BEACH, FL 33169-6051
(305) 944-8887
(877) 488-9590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME69729
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054109
AETNA
FL
05
—
250632700
—
FL
01
—
25649
NHP
FL
01
—
259904
AVMED
FL
01
—
31947
BLUE CROSS BLUE SHIELD
FL
01
—
3421617
CIGNA
FL
Enumeration date
10/23/2007
Last updated
07/22/2024
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