Provider Demographics
NPI:1134678980
Name:PATTON, HIBELIS M (ARNP)
Entity Type:Individual
Prefix:
First Name:HIBELIS
Middle Name:M
Last Name:PATTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 W 68TH ST
Mailing Address - Street 2:STE 403
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1815
Mailing Address - Country:US
Mailing Address - Phone:305-817-1344
Mailing Address - Fax:
Practice Address - Street 1:7100 W 20TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1812
Practice Address - Country:US
Practice Address - Phone:305-817-1344
Practice Address - Fax:305-817-1355
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9305509363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner