Provider Demographics
NPI:1013425271
Name:CAPRI, PATRICK NICHOLAS JR (ACUPUNCTURIST)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:NICHOLAS
Last Name:CAPRI
Suffix:JR
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14003 N DALE MABRY HWY STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2459
Mailing Address - Country:US
Mailing Address - Phone:813-961-9174
Mailing Address - Fax:813-961-7338
Practice Address - Street 1:14003 N DALE MABRY HWY STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2459
Practice Address - Country:US
Practice Address - Phone:813-841-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82-3864992OtherMEDICARE ONLY