Paul Gary Patenaude, PTA 11424 (FL)

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 11424 Issued in FL

Practice address

9393 Park Blvd
Seminole, FL 33777-4140

Phone

(727) 575-7955

Fax

(727) 575-7956

NPI assigned

Mar 19, 2007

Last updated

Mar 28, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1851415558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9393 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774140",
            "telephone_number": "727-575-7955",
            "fax_number": "727-575-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9393 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774140",
            "telephone_number": "727-575-7955",
            "fax_number": "727-575-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATENAUDE",
        "first_name": "PAUL",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "PTA 11424 (FL)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 11424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Jo Parker, OTR/L
• Shirley Watson Paroulek, R.PH.
• John Partington, MA,PT
• Milind Patel, M.D.
• Ruchi Patel
• Susan Jean Patenaude, OTR/L
• Mark Patterson
• Paul F Eckstein DMD PA (E Dental)
• Penny Pearl, LMHC
• Pearle Capstone Eye Associates, PLLC

• Physical Therapy Assistant in Seminole, FL
• Providers in Seminole, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.