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General NPI Number Information
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NPI Number | 1447695184
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Entity Type | Individual
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Provider Name | EBONY PETIT M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 2054 VISTA PKWY STE 400
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-6742
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Country | US
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Telephone | 561-576-7879
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Fax | 866-450-1704
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Provider Business Mailing Address
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Address Line | 2054 VISTA PKWY STE 400
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-6742
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Country | US
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Telephone | 561-576-7879
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Fax | 866-450-1704
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 283643
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 84043
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.152412
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 33936
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME137482
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License Number State | FL
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