Derby, Patrick
Derby, Patrick is an individual health care provider with primary practice located at 4700 N Habana Ave Ste 400 , Tampa FL 33614-7119. He recently has 5 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Derby, Patrick can be contacted via phone (813) 499-0774.Contact Information
Primary practice address
4700 N Habana Ave Ste 400
Tampa FL 33614-7119
Phone: (813) 499-0774
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | PO4422 | Florida |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | PO4422 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | PO4422 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | PO4422 | Florida |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO4422 | Florida |
Profile Details
| NPI number | 1073075222 |
|---|---|
| LBN Legal business name | Derby, Patrick |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2019 |
| Last updated | Mar 10th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073075222 | NPPES |
| Florida | MEDICAID | 114530400 | |
| Florida | Other | 15659126 | |
| Florida | Other | 6605657 | |
| Florida | Other | OPOAV | |
| Florida | Other | 7333506 |
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