John A. Peterson
Hematologist Medical Oncology
1201 5th Ave North Suite 505
St Petersburg
, Florida 33705-1455
John A. Peterson
Hematologist Medical Oncology
1201 5th Ave North Suite 505
St Petersburg
, Florida 33705-1455
(239) 278-3350
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About
Features
Specialties
- Hematologist
- Medical Oncology
Languages spoken
- English
Location
First Address
- John A. Peterson
- 4371 Veronica S Shoemaker Blvd Attn: Credentialing Dept
- Fort Myers, FL
- Zip : 33916-2216
- Fax : (239) 278-3350
- Phone : (239) 274-8200
Second Address
- John A. Peterson
- 1201 5th Ave North Suite 505
- St Petersburg, FL
- Zip : 33705-1455
- Fax : (727) 502-8860
- Phone : (727) 821-0017
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RH0000X | Hematologist | ME0066038 | FL |
| Y | 207RX0202X | Medical Oncology | ME0066038 | FL |
National Provider Identifier
| NPI | 1245211242 |
|---|---|
| Provider Name | John A. Peterson |
| First Address | Fort Myers, FL 33916-2216 |
| Second Address | St Petersburg, FL 33705-1455 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/11/2005 |
| Last Update Date | 18/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110214273 | RR MEDICARE (01) | FL |
| 25719 | BLUE CROSS / BLUE SHIELD (01) | FL |
| 376003100 | (05) | FL |
| F88607 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.