Basic Information
| Provider Information | |||||||||
| NPI: | 1346336211 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANDRES PATRON D.O.,P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10796 PINES BLVD | ||||||||
| Address2: | SUITE #205 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330263919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548855555 | ||||||||
| FaxNumber: | 9548855333 | ||||||||
| Practice Location | |||||||||
| Address1: | 10796 PINES BLVD | ||||||||
| Address2: | SUITE #205 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330263919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548855555 | ||||||||
| FaxNumber: | 9548855333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PATRON | ||||||||
| AuthorizedOfficialFirstName: | ANDRES | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/CEO | ||||||||
| AuthorizedOfficialTelephone: | 9548855555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS6273 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.