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Dr. Ethan James Dean Peterson, MD
Student in an Organized Health Care Education/Training Program in Brandon, Florida
NPI 1891371480

Ethan James Dean Peterson is a Student in an Organized Health Care Education/Training Program based in Brandon, FL. Ethan James Dean Peterson practices in Brandon, FL and has the professional credentials of MD. The NPI Number for Ethan James Dean Peterson is 1891371480 and holds a License No. (Florida).

The current practice location address for Ethan James Dean Peterson is 119 Oakfield Dr, Brandon, FL and can be reached out via phone at 813-681-5551 and via fax at 813-916-2944.

Location: 119 Oakfield Dr, Brandon, FL, 33511-5779
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1891371480
Provider Name
Ethan James Dean Peterson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
119 Oakfield Dr, Brandon, FL, 33511-5779
Phone Number
813-681-5551
Fax Number
813-916-2944
Provider Enumeration Date
03/23/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
119 Oakfield Dr
City
Brandon
State
Florida
Zip
33511-5779
Phone Number
813-681-5551
Fax Number
813-916-2944
person
Provider Business Mailing Address Details
Address
119 Oakfield Dr
City
Brandon
State
Florida
Zip
33511-5779
Phone Number
813-681-5551
Fax Number
813-916-2944
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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