Individual
PETER REED PAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 974-3820
(813) 974-5621
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME39076
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065522800
—
FL
01
—
30382
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/25/2006
Last updated
01/08/2020
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