Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 009465 | FL |
NPI | 1003943325 |
---|---|
Provider Name | Ottavio P Catalano |
First Address | Bradenton, FL 34209-4607 |
Second Address | Bradenton, FL 34209-4607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D546791 | (02) | FL |