Provider Demographics
NPI:1871528794
Name:PATIN, DENNIS J (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:PATIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1611 NW 12TH AVE
Mailing Address - Street 2:BOX 016960 (M851)
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-6358
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:BOX 016960 (M851)
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-6358
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME62362207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3707521-00Medicaid
FL17743Medicare UPIN
FLF34294Medicare UPIN