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General NPI Number Information
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NPI Number | 1982313508
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Entity Type | Organization
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Legal Business Name | PETIT PSYCHIATRY
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 07/10/2025
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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 | PRESIDENT
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Name | EBONY PETIT
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Credential | MD
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Telephone | 205-200-5110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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