Individual
DERECK PETTIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3330 SW 33RD RD, OCALA, FL 34474-7458
(352) 873-9311
Mailing address
8235 SW 72ND PL, GAINESVILLE, FL 32608-8425
(352) 380-2724
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3280462
FL
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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