Healthcare Provider Details

I. General information

NPI: 1598255515
Provider Name (Legal Business Name): LINDA J PETEK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA J KRAUSS APRN

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 PARSONS PARK DR
BRANDON FL
33511-6066
US

IV. Provider business mailing address

116 PARSONS PARK DR
BRANDON FL
33511-6066
US

V. Phone/Fax

Practice location:
  • Phone: 813-684-5255
  • Fax:
Mailing address:
  • Phone: 813-684-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9288656
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9288656
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number9288656
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: