Petta, Maria T

Petta, Maria T is an individual health care provider with primary practice located at 2950 Cleveland Clinic Blvd , Weston FL 33331-3609. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Petta, Maria T can be contacted via phone (954) 659-5290.

Contact Information

Primary practice address
2950 Cleveland Clinic Blvd Weston FL 33331-3609
Phone: (954) 659-5290
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9101530 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9101530 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9101530 Florida

Profile Details

NPI number 1154334704
LBN Legal business name Petta, Maria T
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jun 1st, 2016 - about 10 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 1154334704 NPPES
Florida MEDICAID 291096900

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