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NPI Code Detail

MEDICARE: AMY LASHAY PATRI DMD

MEDICARE: AMY LASHAY PATRI DMD
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
11223G0001XGeneral Practice DentistryDN25994FL

General Provider Information

NPI Number : 1508435116
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LASHAY PATRI DMD
Provider Business Mailing Address
First Line : 16159 MYRIAD LN
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-3483
Country : US
Telephone Number : 239-220-5408
Fax Number :
Provider Business Practice Location Address
First Line : 16159 MYRIAD LN
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-3483
Country : US
Telephone Number : 239-220-5408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2021
Last Update Date : 08/28/2021

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Directions to “ AMY LASHAY PATRI DMD” Practice Location

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