Derrick Dejuan Pettis
NPI #1265637847 in St Petersburg, Florida
Provider Information
- NPI Number
- 1265637847
- Entity Type
- Individual
- Name
- Derrick Dejuan Pettis
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Emergency Medical Technician, Basic
- Enumeration Date
- Jun 15, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 600 8TH AVE SE
- City
- St Petersburg
- State
- Florida
- ZIP Code
- 33701-5030
- Phone
- (727) 502-1602
Specialties & Taxonomy Codes
| Specialty |
|---|
| Emergency Medical Technician, Basic |
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