Provider Demographics
NPI:1700837846
Name:PATRON, DANIEL ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTONIO
Last Name:PATRON
Suffix:
Gender:M
Credentials:MD
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 9240
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9240
Mailing Address - Country:US
Mailing Address - Phone:787-746-2331
Mailing Address - Fax:787-745-2165
Practice Address - Street 1:AVE GAUTIER BENITEZ #202
Practice Address - Street 2:CONSOLIDATED MALL LOCAL CIE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-2331
Practice Address - Fax:787-745-2165
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6158207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D08414Medicare UPIN
0082448AMedicare ID - Type Unspecified