Provider Demographics
NPI:1427213651
Name:MISSALL, PATRICIA ANN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MISSALL
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4037 NW 86TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9277
Mailing Address - Country:US
Mailing Address - Phone:352-594-1500
Mailing Address - Fax:352-594-1926
Practice Address - Street 1:4037 NW 86TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9277
Practice Address - Country:US
Practice Address - Phone:352-594-1500
Practice Address - Fax:352-594-1926
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013017451207N00000X, 207ND0900X
FLME139288207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology