Individual
PATRICIA OLIVIA O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6307
(813) 557-8121
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35121018
OH
208M00000X
Hospitalist Physician
Primary
ME129221
FL
390200000X
Student in an Organized Health Care Education/Training Program
TC57010556
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018497800
—
FL
01
—
H1J7R
BLUE CROSS BLUE SHIELD
FL
01
—
IW040Z
MEDICARE
FL
Enumeration date
05/17/2007
Last updated
10/27/2020
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