Provider Demographics
NPI:1740690676
Name:PATINO, ADRIANA (L,AC)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:PATINO
Suffix:
Gender:F
Credentials:L,AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 BRICKELL AV
Mailing Address - Street 2:APT B307
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1269
Mailing Address - Country:US
Mailing Address - Phone:305-439-2413
Mailing Address - Fax:
Practice Address - Street 1:1550 BRICKELL AVE
Practice Address - Street 2:UNIT B307
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1269
Practice Address - Country:US
Practice Address - Phone:305-439-2413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3427171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist