Provider Demographics
NPI:1518147883
Name:RONQUILLO, PATRICIA MARY (ARNP)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:MARY
Last Name:RONQUILLO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARY
Other - Last Name:ANASTACIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-204-4207
Mailing Address - Fax:
Practice Address - Street 1:5000 UNIVERSITY DR STE 3300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:786-204-4207
Practice Address - Fax:786-533-9735
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3134712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner