Provider Demographics
NPI:1003478082
Name:CAMPOS CATALAN, JOHANNA GUADALUPE (MD)
Entity type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:GUADALUPE
Last Name:CAMPOS CATALAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0296
Mailing Address - Country:US
Mailing Address - Phone:352-627-9350
Mailing Address - Fax:352-273-9054
Practice Address - Street 1:1500 SE 17TH ST STE 600
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4668
Practice Address - Country:US
Practice Address - Phone:352-732-8955
Practice Address - Fax:352-732-7999
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME154981208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115691700Medicaid