Provider Demographics
NPI:1720636442
Name:WASHINGTON, PATRICIA K
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:K
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:K
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4810 ROLLING OAK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8306
Mailing Address - Country:US
Mailing Address - Phone:407-521-8761
Mailing Address - Fax:
Practice Address - Street 1:4810 ROLLING OAK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-8306
Practice Address - Country:US
Practice Address - Phone:407-521-8761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty