Provider Demographics
NPI:1306105838
Name:PETERLIN, JOHN E (DVM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:PETERLIN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 N BAY AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-8951
Mailing Address - Country:US
Mailing Address - Phone:352-613-3163
Mailing Address - Fax:
Practice Address - Street 1:3407 N BAY AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-8951
Practice Address - Country:US
Practice Address - Phone:352-613-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM8755174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian