Individual
DEVAN C. WALICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3222 W AZEELE ST, TAMPA, FL 33609-3280
(813) 872-8491
(813) 872-7766
Mailing address
4033 TAMPA RD, SUITE 101, OLDSMAR, FL 34677-3224
(813) 854-2003
(813) 855-2367
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP 9252149
FL
Other
Enumeration date
10/12/2007
Last updated
05/27/2015
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