Peterson, Frederick

Peterson, Frederick is an individual health care provider with primary practice located at 6100 Minton Rd Nw Ste104, Palm Bay FL 32907-1975. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Peterson, Frederick can be contacted via phone (321) 724-1172.

Contact Information

Primary practice address
6100 Minton Rd Nw Ste104 Palm Bay FL 32907-1975
Phone: (321) 724-1172
Fax: (321) 724-9024
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME32196 Florida

Profile Details

NPI number 1215913165
LBN Legal business name Peterson, Frederick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2005
Last updated Mar 30th, 2021 - about 3 years ago

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 1215913165 NPPES
Florida Other 080185086 RAILROAD MEDICARE
Florida MEDICAID 038494100 RAILROAD MEDICARE
Florida Other 5840654 RAILROAD MEDICARE
Florida Other 2830929 RAILROAD MEDICARE
Florida Other 200859 RAILROAD MEDICARE
Florida Other 62193 RAILROAD MEDICARE
Florida Other 2049145010 RAILROAD MEDICARE

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