Individual
ADRIAN MILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 2ND AVE S, ST PETERSBURG, FL 33701-4360
(727) 490-6769
Mailing address
100 2ND AVE S, ST PETERSBURG, FL 33701-4360
(727) 490-6769
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0000000000000
FL
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060590500
VILLAGE SOUTH GROUP MEDICAID NUMBER
FL
01
—
075852300
WESTCARE GULCOAST FLORIDA'S GROUP MEDICAID
FL
Enumeration date
10/25/2016
Last updated
10/25/2016
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