Individual
ANGELA BOWERSOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 7TH ST S STE 205, ST PETERSBURG, FL 33701-4708
(727) 893-6234
(727) 893-6111
Mailing address
601 7TH ST S STE 205, ST PETERSBURG, FL 33701-4708
(727) 893-6234
(727) 893-6111
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9108656
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014874000
—
FL
Enumeration date
10/19/2005
Last updated
03/05/2020
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