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DERRICK DEJUAN PETTIS NPI 1265637847


NPI Information

NPI: 1265637847
Provider Name: DERRICK DEJUAN PETTIS
Classification: Emergency Medical Technician, Basic - 146N00000X
Entity Type: Individual
Address:
600 8TH AVE SE
ST PETERSBURG, FL
ZIP 33701
Phone: (727) 502-1602
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Derrick Dejuan Pettis is an emergency medical technician basic in St Petersburg, FL. The provider is a Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. Derrick Dejuan Pettis NPI is 1265637847. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

600 8TH AVE SE
ST PETERSBURG, FL
ZIP 33701-030
Phone: (727) 502-1602
Fax: (727) 502-1603

The enumeration date for this NPI number is 6/15/2007 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1146N00000XEmergency Medical Technician, BasicB1026491FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.