| Entity Name: | W. PATRICK DANZEY D.C., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Mar 1987 (38 years ago) |
| Document Number: | J62405 |
| FEI/EIN Number | 592782684 |
| Address: | 1590 HIGHWAY 27 NORTH, AVON PARK, FL, 33825 |
| Mail Address: | 1590 HIGHWAY 27 NORTH, AVON PARK, FL, 33825 |
| ZIP code: | 33825 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194031732 | 2010-08-20 | 2012-07-06 | 1590 US 27 N, AVON PARK, FL, 338252151, US | 1590 US 27 N, AVON PARK, FL, 338252151, US | |||||||||||||||||||||
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| Phone | +1 863-453-5777 |
| Fax | 8634539737 |
Authorized person
| Name | MR. WILLIAM PATRICK DANZEY |
| Role | OWNER |
| Phone | 8634535777 |
Taxonomy
| Taxonomy Code | 111NI0013X - Independent Medical Examiner Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002887000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DANZEY, W. PATRICK | Agent | 1590 HIGHWAY 27 NORTH, AVON PARK, FL, 33825 |
| Name | Role | Address |
|---|---|---|
| Danzey William PDr. | Director | 1590 HIGHWAY 27 NORTH, AVON PARK, FL, 33825 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
