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General NPI Number Information
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NPI Number | 1376422113
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Entity Type | Organization
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Legal Business Name | PATRICK MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 6882 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144-2814
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Country | US
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Telephone | 786-350-6080
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Fax |
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Provider Business Mailing Address
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Address Line | 15585 SW 112TH WAY
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City | MIAMI
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State | FL
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Zip | 33196-5301
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Country | US
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Telephone | 786-350-6080
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA T ROQUE PEREIRA
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Credential |
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Telephone | 786-716-0059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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