Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | ME46899 | FL |
NPI | 1295777506 |
---|---|
Provider Name | Perry Boyd Everett |
First Address | St Petersburg, FL 33701-1547 |
Second Address | St Petersburg, FL 33701-1547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041718100 | (05) | FL |
D57505 | (02) | FL |