Burkett, Patricia Polk

Burkett, Patricia Polk is an individual health care provider with primary practice located at 1201 5Th Ave N , St Petersburg FL 33705-1400. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Burkett, Patricia Polk can be contacted via phone (727) 821-0017.

Contact Information

Primary practice address
1201 5Th Ave N St Petersburg FL 33705-1400
Fax: (727) 822-7473
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY4694 Florida

Profile Details

NPI number 1720079932
LBN Legal business name Burkett, Patricia Polk
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jun 30th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720079932 NPPES
Florida MEDICAID 254016941

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