MEDICARE: CHRISTOPHER PATINO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	9348711	FL
2	363LG0600X	Gerontology Nurse Practitioner	APRN9348711	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053895078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER PATINO

Provider Business Mailing Address
First Line	:	18741 NW 24TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-5352
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2030 S DOUGLAS RD STE 201
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4615
Country	:	US
Telephone Number	:	786-882-2261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2018
Last Update Date	:	04/28/2025

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Directions to “ CHRISTOPHER PATINO ” Practice Location

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