Provider Demographics
NPI:1760993786
Name:VERGEL DE DIOS, PATRICK AQUINO (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:AQUINO
Last Name:VERGEL DE DIOS
Suffix:
Gender:M
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:1801 SE HILLMOOR DR STE A-107
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7545
Mailing Address - Country:US
Mailing Address - Phone:772-446-0950
Mailing Address - Fax:772-446-0956
Practice Address - Street 1:1801 SE HILLMOOR DR STE A-107
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7545
Practice Address - Country:US
Practice Address - Phone:772-446-0950
Practice Address - Fax:772-446-0956
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2338961207P00000X, 363L00000X, 363LC1500X
FLARNP9331457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health