Healthcare Provider Details

I. General information

NPI: 1124003686
Provider Name (Legal Business Name): BEVIN PATRICIA WEEKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH ST S STE 2
ST PETERSBURG FL
33701
US

IV. Provider business mailing address

601 5TH ST S STE 2
ST PETERSBURG FL
33701-4804
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-3333
  • Fax: 727-767-8990
Mailing address:
  • Phone: 727-767-3333
  • Fax: 727-767-8990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME129318
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: