Healthcare Provider Details

I. General information

NPI: 1285371211
Provider Name (Legal Business Name): PATRICE ERIC NASNAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD
MIAMI FL
33140-2948
US

IV. Provider business mailing address

601 NE 36TH ST APT 2403
MIAMI FL
33137-3970
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2273
  • Fax:
Mailing address:
  • Phone: 713-277-5195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number706N
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: