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General NPI Number Information
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NPI Number | 1720399579
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Entity Type | Individual
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Provider Name | JOSE A PATINO D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2010
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 3275 W HILLSBORO BLVD STE 210
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-9476
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Country | US
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Telephone | 954-825-8490
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Fax |
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Provider Business Mailing Address
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Address Line | 9407 NW 74TH PL
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City | TAMARAC
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State | FL
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Zip | 33321-2312
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Country | US
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Telephone | 954-825-8490
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 10029
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License Number State | FL
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