MEDICARE: DR. DANIEL AARON PATZ PSY.D., LMHC

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	101YM0800X	Mental Health Counselor	MH6401	FL
2	103T00000X	Psychologist	PY7669	FL
3	103TC0700X	Clinical Psychologist	002577	CT

General Provider Information

NPI Number	:	1558548081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL AARON PATZ PSY.D., LMHC

Provider Business Mailing Address
First Line	:	2706 W SAINT ISABEL ST
Second Line	:	SUITE B
City	:	TAMPA
State	:	FL
Zip	:	33607-6382
Country	:	US
Telephone Number	:	888-666-3089
Fax Number	:	888-666-9870

Provider Business Practice Location Address
First Line	:	2706 W SAINT ISABEL ST
Second Line	:	SUITE B
City	:	TAMPA
State	:	FL
Zip	:	33607-6382
Country	:	US
Telephone Number	:	888-666-3089
Fax Number	:	888-666-9870

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

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	07/25/2016

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