PREM FORT

ST PETERSBURG, FL
NPI1639345580
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2080N0001X Pediatrics, Neonatal-Perinatal Medicine
(Licence: FL  ME123447)
Enumeration Date2008-05-01
Last Update Date2016-06-24
Business Address
-- PREM FORT MD
501 6TH AVE S
ST PETERSBURG, FL 33701-4634
Phone number: 727-767-4313
Mailing Address
-- PREM FORT MD
501 6TH AVE S
ST PETERSBURG, FL 33701-4634
Phone number: 727-767-4313
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