Individual
MISS PATRICIA CAROLINA SUBNAIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
15901 BASS RD STE 102, FORT MYERS, FL 33908
(239) 343-9890
(239) 343-9898
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9890
(239) 343-9898
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
03869
KY
2080P0206X
Pediatric Gastroenterology Physician
Primary
OS16079
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103021200
—
FL
Enumeration date
03/26/2012
Last updated
03/30/2021
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