Derrick Dejuan Pettis in St Petersburg - Emergency Medical Technician, Basic
Derrick Dejuan Pettis - NPI 1265637847
Derrick Dejuan Pettis is a Emergency Medical Technician, Basic in St Petersburg, Florida. Derrick Dejuan Pettis practices all healthcare services and medical treatments related to Emergency Medical Technician, Basic. The NPI Number for Derrick Dejuan Pettis is 1265637847. The last update date is 2007-07-08.
Derrick Dejuan Pettis's current location address is 600 8th Ave Se, St Petersburg, Florida. You can contact this provider via phone number 7275021602 and fax number 7275021603. The mailing address for Derrick Dejuan Pettis is 600 8th Ave Se, St Petersburg, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derrick Dejuan Pettis |
|---|---|
| Address | 600 8th Ave Se, St Petersburg, Florida |
| Phone Number | 7275021602 |
| Fax Number | 7275021603 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1265637847 |
|---|---|
| Provider Enumeration Date | 2007-06-15 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 600 8th Ave Se |
|---|---|
| City | St Petersburg |
| State | Florida (FL) |
| Post Code | 337015030 |
| Phone Number | 7275021602 |
| Fax Number | 7275021603 |
Provider's Primary Taxonomy Detail
| Speciality | Emergency Medical Technician, Basic |
|---|---|
| Taxonomy | 146N00000X |
| Licence No | B1026491 |
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Definition: A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
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Post Comment/ Review Below
What is the unique identification code assigned to Derrick Dejuan Pettis by the Centers for Medicare & Medicaid Services?
The Derrick Dejuan Pettis has been issued the NPI (National Provider Identifier) 1265637847. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Derrick Dejuan Pettis?
The Derrick Dejuan Pettis is physically situated at 600 8Th Ave Se, in the city of St Petersburg, state of FL, with the postal code 337015030.
What is Derrick Dejuan Pettis's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Derrick Dejuan Pettis's specialized field of practice is Emergency Medical Technician, Basic, and the corresponding taxonomy code that categorizes this area of specialization is 146N00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1265637847 to Derrick Dejuan Pettis?
The Centers for Medicare & Medicaid Services originally issued the 1265637847 to Derrick Dejuan Pettis on 2007-06-15.
When was the information related to Derrick Dejuan Pettis most recently updated or refreshed?
The details pertaining to the Derrick Dejuan Pettis, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.