Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | TRN5870 | FL |
NPI | 1003831389 |
---|---|
Provider Name | Kristin Patrick |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-4742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |