Individual
MURIEL CHRISTINE LADD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 6TH AVE S, DEPT 6500000408, ST PETERSBURG, FL 33701-4634
(727) 767-8480
(727) 767-8420
Mailing address
3126 W HAWTHORNE RD, TAMPA, FL 33611-2901
(352) 514-2130
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAT 9107774
FL
363AM0700X
Medical Physician Assistant
Primary
PA9107774
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012016900
—
FL
Enumeration date
01/23/2014
Last updated
07/27/2016
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