Individual
PATRICIA MISTRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7901 VETERANS PKWY, COLUMBUS, GA 31909-1723
(706) 321-1223
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001896
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00426912
RAILROAD MEDICARE
—
Enumeration date
06/30/2006
Last updated
01/17/2008
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