Male or Other

Michael Peterson

Family Medicine Physician in Jacksonville, FL(View on Map)

Full Name

Michael Peterson

NPI Number

1184037020

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/09/2014

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

Florida
Florida

License Number

OS13490
UO 3884

Contact
Information

Purpose

Mailing
Location

Address

2627 RIVERSIDE AVE
2627 RIVERSIDE AVE

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32204-4712
32204-4712

Country

US
US

Telephone Number

(904) 308-7372
(904) 308-7372

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/04/2016

Provider Address

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