Provider Demographics
NPI:1336370345
Name:PATARCA, ROBERTO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:PATARCA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16445 COLLINS AVE APT 328
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4562
Mailing Address - Country:US
Mailing Address - Phone:305-940-9047
Mailing Address - Fax:305-354-4707
Practice Address - Street 1:16445 COLLINS AVE APT 328
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4562
Practice Address - Country:US
Practice Address - Phone:305-940-9047
Practice Address - Fax:305-354-4707
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 75294207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine