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NPI Code Detail

MEDICARE: DAVID PATLAK

MEDICARE:   DAVID  PATLAK
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
1146N00000XBasic Emergency Medical TechnicianEMT552554FL

General Provider Information

NPI Number : 1922502434
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID PATLAK
Provider Business Mailing Address
First Line : 1881 WASHINGTON AVE APT 2H
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-7445
Country : US
Telephone Number : 305-519-4412
Fax Number :
Provider Business Practice Location Address
First Line : 1881 WASHINGTON AVE APT 2H
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-7445
Country : US
Telephone Number : 305-519-4412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2018
Last Update Date : 06/16/2018

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Directions to “ DAVID PATLAK ” Practice Location

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