Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 35.054631 | OH |
Y | 2080P0210X | Pediatric Nephrologist | ME135748 | FL |
NPI | 1225060908 |
---|---|
Provider Name | Larry T Patterson |
First Address | Gainesville, FL 32610-3003 |
Second Address | Gainesville, FL 32610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 31/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025188400 | (05) | FL |