Healthcare Provider Details

I. General information

NPI: 1558548081
Provider Name (Legal Business Name): DANIEL AARON PATZ PSY.D., LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 W SAINT ISABEL ST SUITE B
TAMPA FL
33607-6382
US

IV. Provider business mailing address

2706 W SAINT ISABEL ST SUITE B
TAMPA FL
33607-6382
US

V. Phone/Fax

Practice location:
  • Phone: 888-666-3089
  • Fax: 888-666-9870
Mailing address:
  • Phone: 888-666-3089
  • Fax: 888-666-9870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH6401
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY7669
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number002577
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: