Organization Name: | FREDDIE L MCRAE MD PA |
NPI Number: | 1417274937 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CATHERINE M BARBER (MANAGER) |
Mailing Address: | 603 7th St S Ste 520 St Petersburg |
State: | FL US |
Postal Code: | 337014734 |
Phone Number: | 7278936500 |
Fax Number: | 7278936503 |
NPI Enumeration Date: | 04/23/2010 |
NPI Last Update Date: | 04/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME28142 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |