Derby, Patrick
Derby, Patrick is an individual health care provider with primary practice located at 2511 W Dr Martin Luther King Jr Blvd , Tampa FL 33607-6301. He recently has 5 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Derby, Patrick can be contacted via phone (813) 879-7850.Contact Information
Primary practice address
2511 W Dr Martin Luther King Jr Blvd
Tampa FL 33607-6301
Phone: (813) 879-7850
Fax: (813) 870-3569
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO4422 | Florida |
| 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 Surgery | 213ES0131X | PO4422 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 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 | Feb 19th, 2024 - 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 | Other | OPOAV | BCBS |
| Florida | Other | 7333506 | BCBS |
| Florida | MEDICAID | 114530400 | BCBS |
| Florida | Other | 6605657 | BCBS |
| Florida | Other | 15659126 | BCBS |
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