Individual
PETE FRANKLIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 DAVIS BLVD, SUITE 308, TAMPA, FL 33606-3475
(813) 259-8510
(813) 259-8660
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
148856
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110963100
—
FL
01
—
OZOJO
BCBS
FL
Enumeration date
03/29/2016
Last updated
08/25/2021
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