Provider Demographics
NPI:1245613959
Name:PATTERSON-BRANAM, LATOYA DENISE (DO)
Entity Type:Individual
Prefix:DR
First Name:LATOYA
Middle Name:DENISE
Last Name:PATTERSON-BRANAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 MADISON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1971
Mailing Address - Country:US
Mailing Address - Phone:727-815-7208
Mailing Address - Fax:727-266-4951
Practice Address - Street 1:6600 MADISON ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1971
Practice Address - Country:US
Practice Address - Phone:727-815-7208
Practice Address - Fax:727-266-4951
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14480208M00000X, 207R00000X
FLUO4605207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100444800Medicaid