Individual
PAMELA A TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2299 9TH AVENUE NORTH, SUITE 1D, SAINT PETERSBURG, FL 33713
(727) 328-1841
(727) 328-2640
Mailing address
2299 9TH AVENUE NORTH, SUITE 1D, SAINT PETERSBURG, FL 33713
(727) 328-1841
(727) 328-2640
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
ME51658
FL
207NS0135X
Procedural Dermatology Physician
Primary
ME51658
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04579
BLUE SHIELD
—
Enumeration date
09/20/2006
Last updated
11/23/2010
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