Provider Demographics
NPI:1437406733
Name:IGAR, PATRICIA (CSCS, LMT, RYT)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:
Last Name:IGAR
Suffix:
Gender:F
Credentials:CSCS, LMT, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5229 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1807
Mailing Address - Country:US
Mailing Address - Phone:727-776-7687
Mailing Address - Fax:
Practice Address - Street 1:6626 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1331
Practice Address - Country:US
Practice Address - Phone:727-776-7687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA53573171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor