Individual provider · NPI-1

Patrick Joseph Fitzgerald, MD

Internal Medicine, Cardiovascular Disease · Crestview, FL

NPI number1306378674
StatusActive
Last updated in NPPESJul 21, 2025

Details

NPI
1306378674
Entity type
Individual (NPI-1)
Name
Patrick Joseph Fitzgerald
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Mar 28, 2017
Certification date
Jul 21, 2025
Last updated
Jul 21, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RC0000X Internal Medicine, Cardiovascular DiseaseME175596FLYes
207R00000X Internal MedicineME139837FL
207R00000X Internal Medicine01085784AIN
207R00000X Internal MedicineTRN24428FL
207R00000X Internal MedicineME175596FL

Practice location

129 E Redstone Ave Ste A
Crestview, FL 32539-5350

Phone 850-682-7212 · Fax 850-682-0220

Mailing address

129 E Redstone Ave Ste A
Crestview, FL 32539-5350

Phone 850-682-7212 · Fax 850-682-0220

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