Healthcare Provider Details

I. General information

NPI: 1265511695
Provider Name (Legal Business Name): MR. PATRICIO EDUARDO OGRODNIK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10661 N KENDALL DR SUITE 220
MIAMI FL
33176-1550
US

IV. Provider business mailing address

14201 SW 88TH ST APT. 103D
MIAMI FL
33186-1191
US

V. Phone/Fax

Practice location:
  • Phone: 305-490-2847
  • Fax:
Mailing address:
  • Phone: 305-388-0158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberMA 18912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: