Provider Demographics
NPI:1477396257
Name:VEITIA, PATRICIA B
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:VEITIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11541 NW 2ND ST APT 212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4951
Mailing Address - Country:US
Mailing Address - Phone:305-360-4849
Mailing Address - Fax:
Practice Address - Street 1:440 SAWGRASS CORPORATE PKWY STE 106
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33325-6236
Practice Address - Country:US
Practice Address - Phone:954-745-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLV355-682-98-944-0106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician