Individual
KEITH R PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0291
(352) 265-0279
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-0291
(352) 265-0279
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME56329
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME56329
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064699700
—
FL
Enumeration date
02/01/2006
Last updated
03/26/2008
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