Organization
OPTUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRELL L PETERS ARNP-BC (NURSE PRACTITIONER)
(813) 293-4609
Entity
Organization
Contact information
Practice address
701 N WILDER RD, PLANT CITY, FL 33566-7547
(813) 293-4609
Mailing address
701 N WILDER RD, PLANT CITY, FL 33566-7547
(813) 293-4609
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
ARNP9285722
FL
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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