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General NPI Number Information
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NPI Number | 1669568861
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Entity Type | Individual
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Provider Name | PATRICIA DEVILLIERS DDS
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 1344 22ND ST S
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City | ST. PETERSBURG
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State | FL
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Zip | 33712-8757
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Country | US
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Telephone | 205-790-5866
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Fax | 727-824-8165
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Provider Business Mailing Address
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Address Line | 14100 58TH STREET NORTH
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City | CLEARWATER
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State | FL
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Zip | 33760
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Country | US
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Telephone |
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Fax |
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 5530
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 5530
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | DN21483
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN21483
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | DN21483
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License Number State | FL
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