Healthcare Provider Details

I. General information

NPI: 1679901557
Provider Name (Legal Business Name): PATRICK OGRODNIK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2013
Last Update Date: 04/20/2024
Certification Date: 04/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 SW 116TH CT APT 101
MIAMI FL
33173-1746
US

IV. Provider business mailing address

6701 SW 116TH CT APT 101
MIAMI FL
33173-1746
US

V. Phone/Fax

Practice location:
  • Phone: 786-280-5932
  • Fax:
Mailing address:
  • Phone: 786-280-5932
  • 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 Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-72524
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: