Provider Demographics
NPI:1932292935
Name:PATRINELY, JAMES RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RANDALL
Last Name:PATRINELY
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 1:17 E MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5998
Mailing Address - Country:US
Mailing Address - Phone:850-473-0990
Mailing Address - Fax:850-473-0790
Practice Address - Street 1:17 E MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-5998
Practice Address - Country:US
Practice Address - Phone:850-473-0990
Practice Address - Fax:850-473-0790
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49837207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1629161633OtherGROUP NPI
TX0043BMOtherMEDICARE GROUP
TX1235222167OtherGROUP NPI
1932292935OtherINDIVIDUAL NPI
TX85060FOtherMEDICARE
TX0043BMOtherMEDICARE GROUP
FLE0481Medicare PIN