Individual
DR. VIRGINIA BURNS PETITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4340 NEWBERRY RD., SUITE 301, GAINESVILLE, FL 32607-2557
(352) 372-9414
(352) 271-5393
Mailing address
4340 NEWBERRY RD., SUITE 301, GAINESVILLE, FL 32607-2557
(352) 372-9414
(352) 271-5393
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME63378
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18447
BLUE CROSS BLUE SHIELD FL
FL
01
—
18447Y
MEDICARE ID
FL
05
—
371991000
—
FL
Enumeration date
03/24/2006
Last updated
07/16/2014
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