Healthcare Provider Details

I. General information

NPI: 1235048935
Provider Name (Legal Business Name): PATREEKA K HART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2769 CHADDSFORD CIR APT 203
OVIEDO FL
32765-7261
US

IV. Provider business mailing address

2769 CHADDSFORD CIR APT 203
OVIEDO FL
32765-7261
US

V. Phone/Fax

Practice location:
  • Phone: 954-709-6613
  • Fax:
Mailing address:
  • Phone: 954-709-6613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number9099
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: