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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NPI Details

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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: 11/21/2025

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