Provider Demographics
NPI:1073905964
Name:PATTITUDE INC
Entity Type:Organization
Organization Name:PATTITUDE INC
Other - Org Name:REALM CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSMELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-886-8824
Mailing Address - Street 1:8523 W. HILLSBOROUGH AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615
Mailing Address - Country:US
Mailing Address - Phone:813-886-8824
Mailing Address - Fax:813-888-5581
Practice Address - Street 1:8523 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3809
Practice Address - Country:US
Practice Address - Phone:813-888-6882
Practice Address - Fax:813-888-5581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty