Individual
DR. LISA E PETITFILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 7TH AVE N, ST PETERSBURG, FL 33705-1348
(727) 822-5393
Mailing address
1722 FAIRWAY AVE S, ST PETERSBURG, FL 33712-4227
(727) 867-6174
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME79404
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261764100
—
FL
Enumeration date
08/12/2006
Last updated
11/21/2012
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