Provider Demographics
NPI:1417099235
Name:PATS PERFECT FIT
Entity Type:Organization
Organization Name:PATS PERFECT FIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:CMOF
Authorized Official - Phone:352-377-6060
Mailing Address - Street 1:3432 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2403
Mailing Address - Country:US
Mailing Address - Phone:352-377-6060
Mailing Address - Fax:352-377-6061
Practice Address - Street 1:3432 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2403
Practice Address - Country:US
Practice Address - Phone:352-377-6060
Practice Address - Fax:352-377-6061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280446OtherAV-MED
FLM2565OtherBLUE CROSS
FL280446OtherAV-MED