MR. IVAN PATINO, PA-C
Medical Practice at Aventura Blvd, Miami, FL

License number
Florida PA9102100
Category
Nursing
Type
Medical
Address
Address
2845 Aventura Blvd #240, Miami, FL 33180
Phone
(305) 931-9002
(305) 692-9176 (Fax)
(305) 256-3510
National Provider ID: 1861560427
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about IVAN PATINO at bizstanding.com

IVAN PATINO PA-C, PA

Miami, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jan 20, 2004
Inactive since:
Sep 16, 2005
Addresses:
12300 SW 123 Psge, Miami, FL 33186 (Physical)
12300 SW 123 Pass, Miami, FL 33186
State ID:
P04000014876
Business type:
Florida Profit Corporation
President:
Ivan Patino President, inactive, 12300 SW 123 Psge, Miami, FL 33186 (Physical)
Agent:
Patino, Ivan,12300 SW 123 Psge, Miami, FL 33186 (Physical)
EIN:
NO-NE

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