| Doctor Name: | PAULINE PETERKIN |
| NPI Number: | 1174743728 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 1473942 |
| Business Practice Address: | 10300 Sw 216th St Cutler Bay, FL - 331901003 |
| Business Phone Number: | 3052535100 |
| Business Fax Number: | 3052525881 |
| Mailing Address: | 10300 Sw 216th St, CUTLER BAY |
| State: | FL |
| Postal Code: | 331901003 |
| Phone Number: | 3052535100 |
| Fax Number: | 3052525881 |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 09/13/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 1473942 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |