Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | ME70272 | FL |
N | 207NS0135X | Procedural Dermatology | ME70272 | FL |
N | 208200000X | Surgeon | ME70272 | FL |
N | 208600000X | Surgeon | ME70272 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME70272 | FL |
NPI | 1306859517 |
---|---|
Provider Name | Croce Stephen Patti |
First Address | Sarasota, FL 34233-1504 |
Second Address | Sarasota, FL 34233-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 29/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G64836 | (02) |