Individual
MRS. TERESA E PEAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4950 34TH ST N, ST PETERSBURG, FL 33714-3031
(727) 824-8181
Mailing address
14100 58TH ST N, CLEARWATER, FL 33760-9900
(172) 750-3534
(727) 895-3762
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9109039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9109039
FLORIDA LICENSE
FL
Enumeration date
09/23/2015
Last updated
04/15/2024
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