Provider Demographics
NPI:1710173380
Name:DAMATO, PATRICIA MCENROE (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MCENROE
Last Name:DAMATO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 SW COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6042
Mailing Address - Country:US
Mailing Address - Phone:772-873-3770
Mailing Address - Fax:772-344-8690
Practice Address - Street 1:484 SW COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6042
Practice Address - Country:US
Practice Address - Phone:772-873-3770
Practice Address - Fax:772-344-8690
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360404-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse