Individual
DIANA LEE SEVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5126 CASILLA WAY S, ST PETERSBURG, FL 33712-4261
(727) 804-4153
(727) 867-1536
Mailing address
5126 CASILLA WAY S, ST PETERSBURG, FL 33712-4261
(727) 804-4153
(727) 867-1536
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
693544396
FL
174400000X
Specialist
693544398
FL
Other
Enumeration date
12/14/2008
Last updated
12/16/2008
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