Provider Demographics
NPI:1902680440
Name:PATETE, PHILIP (PHD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:PATETE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4495
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33008-4495
Mailing Address - Country:US
Mailing Address - Phone:954-237-4200
Mailing Address - Fax:
Practice Address - Street 1:1845 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4619
Practice Address - Country:US
Practice Address - Phone:954-900-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach