Provider Demographics
NPI:1538187158
Name:PATE, DAVID A (CRNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:PATE
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25007
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2007
Mailing Address - Country:US
Mailing Address - Phone:941-365-6611
Mailing Address - Fax:888-990-1363
Practice Address - Street 1:950 S TAMIAMI TRL STE 210
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7818
Practice Address - Country:US
Practice Address - Phone:941-365-6611
Practice Address - Fax:888-990-1363
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2025-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-045071363L00000X
FLAPRN11012019363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051504239OtherBLUE CROSS BLUE SHIELD
AL051504239OtherBLUE CROSS BLUE SHIELD
ALP28888Medicare UPIN