Provider Demographics
NPI:1689835233
Name:PATRICE C CASE M D PA
Entity Type:Organization
Organization Name:PATRICE C CASE M D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-263-6666
Mailing Address - Street 1:700 2ND AVE N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5756
Mailing Address - Country:US
Mailing Address - Phone:239-263-6666
Mailing Address - Fax:239-263-6163
Practice Address - Street 1:700 2ND AVE N
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5756
Practice Address - Country:US
Practice Address - Phone:239-263-6666
Practice Address - Fax:239-263-6163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39722207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN
FL=========OtherEIN