DERRICK DEJUAN PETTIS

ST PETERSBURG, FL
NPI1265637847
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy146N00000X Emergency Medical Technician, Basic
(Licence: FL  B1026491)
Enumeration Date2007-06-15
Last Update Date2007-07-08
Business Address
-- DERRICK DEJUAN PETTIS
600 8TH AVE SE
ST PETERSBURG, FL 33701-5030
Phone number: 727-502-1602
Mailing Address
-- DERRICK DEJUAN PETTIS
11150 4TH ST N APT 4301
ST PETERSBURG, FL 33716-2909
Phone number:
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