Healthcare Provider Details

I. General information

NPI: 1609869619
Provider Name (Legal Business Name): PATRICIA FLETCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E VENICE AVE STE B
VENICE FL
34285-7160
US

IV. Provider business mailing address

3820 NORTHDALE BLVD STE 201 STE 201
TAMPA FL
33624-1893
US

V. Phone/Fax

Practice location:
  • Phone: 800-991-6117
  • Fax: 888-812-8191
Mailing address:
  • Phone: 800-991-6117
  • Fax: 888-812-8191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number11623
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME181151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: