1437327293 NPI number — DR. RONALDO RODRIGUEZ PATIAG M.D.

Table of content: DR. RONALDO RODRIGUEZ PATIAG M.D. (NPI 1437327293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437327293 NPI number — DR. RONALDO RODRIGUEZ PATIAG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATIAG
Provider First Name:
RONALDO
Provider Middle Name:
RODRIGUEZ
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437327293
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5147 N 9TH AVE
Provider Second Line Business Mailing Address:
SUITE 322
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32504-8771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-439-5681
Provider Business Mailing Address Fax Number:
850-439-5682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 BORTHWICK AVE STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03801-7111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-433-8733
Provider Business Practice Location Address Fax Number:
603-433-8834
Provider Enumeration Date:
02/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  19539 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)