Individual
MR. ETHAN JAMES DEAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13000 BRUCE B DOWN'S BLVD, TAMPA, FL 33612
(813) 972-2000
(813) 916-2944
Mailing address
13000 BRUCE B DOWN'S BLVD, TAMPA, FL 33612
(813) 681-5551
(813) 916-2944
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME165685
FL
Other
Enumeration date
03/23/2021
Last updated
09/10/2024
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