Provider Demographics
NPI:1265511695
Name:OGRODNIK, PATRICIO EDUARDO
Entity Type:Individual
Prefix:MR
First Name:PATRICIO
Middle Name:EDUARDO
Last Name:OGRODNIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 SW 88TH ST
Mailing Address - Street 2:APT. 103D
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1191
Mailing Address - Country:US
Mailing Address - Phone:305-388-0158
Mailing Address - Fax:
Practice Address - Street 1:10661 N KENDALL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1550
Practice Address - Country:US
Practice Address - Phone:305-490-2847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 18912175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath