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Individual

PATRICK GORRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
2600 BUCKINGHAM RD, FORT MYERS, FL 33905-2499
(000) 000-0000
Mailing address
2600 BUCKINGHAM RD, FORT MYERS, FL 33905-2499

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4508
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AL4508
FLORIDA BOARD OF ATHLETIC TRAINING
FL
Enumeration date
05/25/2016
Last updated
09/14/2020
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