TISHA DELISE VAN PELT

TAMPA, FL
NPI1982233938
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  ME153152)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-04-02
Last Update Date2024-05-22
Business Address
TISHA DELISE VAN PELT
17 DAVIS BLVD STE 308
TAMPA, FL 33606-3438
Phone number: 727-462-7000
Mailing Address
TISHA DELISE VAN PELT
2995 DREW ST
CLEARWATER, FL 33759-3012
Phone number: 727-315-7496