Individual
DOUGLAS J PEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1220 S DALE MABRY HWY, SUITE 201, TAMPA, FL 33629-5019
(727) 417-4997
Mailing address
1220 S DALE MABRY HWY, SUITE 201, TAMPA, FL 33629-5019
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
251B00000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011807700
—
FL
Enumeration date
06/22/2016
Last updated
06/22/2016
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