Provider Demographics
NPI:1336161454
Name:EAR NOSE THROAT & SINUS CENTER PA
Entity Type:Organization
Organization Name:EAR NOSE THROAT & SINUS CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATETE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:941-485-7783
Mailing Address - Street 1:213 PALERMO PL
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2821
Mailing Address - Country:US
Mailing Address - Phone:941-485-7783
Mailing Address - Fax:941-484-9188
Practice Address - Street 1:213 PALERMO PL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2821
Practice Address - Country:US
Practice Address - Phone:941-485-7783
Practice Address - Fax:941-484-9188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57749174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF66274Medicare UPIN
FL23201Medicare PIN