Provider Demographics
NPI:1659565380
Name:KEEFE, PATTI K (CFA)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:K
Last Name:KEEFE
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 953908
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-3908
Mailing Address - Country:US
Mailing Address - Phone:407-328-0825
Mailing Address - Fax:
Practice Address - Street 1:353 CEDARBROOK LN
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3621
Practice Address - Country:US
Practice Address - Phone:407-782-6110
Practice Address - Fax:407-788-1644
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL93052246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant