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General NPI Number Information
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NPI Number | 1336161454
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Entity Type | Organization
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Legal Business Name | EAR NOSE THROAT & SINUS CENTER PA
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 213 PALERMO PL
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City | VENICE
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State | FL
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Zip | 34285-2821
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Country | US
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Telephone | 941-485-7783
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Fax | 941-484-9188
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Provider Business Mailing Address
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Address Line | 213 PALERMO PL
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City | VENICE
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State | FL
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Zip | 34285-2821
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Country | US
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Telephone | 941-485-7783
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Fax | 941-484-9188
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL L. PATETE
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Credential | M.D., F.A.C.S
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Telephone | 941-485-7783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME57749
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License Number State | FL
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