Provider Demographics
NPI:1710002274
Name:DRANGINIS, PATRICIA LOUISE (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LOUISE
Last Name:DRANGINIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:LOUISE
Other - Last Name:DRANGINIS-SHULMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:93 CUNNINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-5905
Mailing Address - Country:US
Mailing Address - Phone:386-428-7811
Mailing Address - Fax:
Practice Address - Street 1:93 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-5905
Practice Address - Country:US
Practice Address - Phone:386-428-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 4401207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF10103Medicare UPIN
FL82471BMedicare ID - Type Unspecified