Provider Demographics
NPI:1912863606
Name:RIDOLFI, PATRICIA (PH1, ML1)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:RIDOLFI
Suffix:
Gender:F
Credentials:PH1, ML1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19732 E COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2527
Mailing Address - Country:US
Mailing Address - Phone:786-683-5613
Mailing Address - Fax:
Practice Address - Street 1:19732 E COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2527
Practice Address - Country:US
Practice Address - Phone:786-683-5613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-27
Last Update Date:2025-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33710325246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty