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General NPI Number Information
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NPI Number | 1205579711
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Entity Type | Individual
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Provider Name | MELISSA PATINO
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 8333 NW 53RD ST STE 450
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City | DORAL
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State | FL
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Zip | 33166-4837
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Country | US
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Telephone | 305-300-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 2075 SW 122ND AVE APT 505
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City | MIAMI
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State | FL
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Zip | 33175-7339
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Country | US
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Telephone | 305-833-6245
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11019168
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License Number State | FL
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