Healthcare Provider Details

I. General information

NPI: 1326515099
Provider Name (Legal Business Name): PATRICIA MICHELLE VIRGIL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA MICHELLE VIRGIL-BRYANT NONE

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

IV. Provider business mailing address

8881 NW 5TH ST
PEMBROKE PINES FL
33024-6513
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-7000
  • Fax: 305-575-3437
Mailing address:
  • Phone: 954-740-1356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number9211535
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: