Provider Demographics
NPI:1700552049
Name:CATALAN, VICKY ATALA
Entity type:Individual
Prefix:
First Name:VICKY
Middle Name:ATALA
Last Name:CATALAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1592
Mailing Address - Street 2:
Mailing Address - City:MANGO
Mailing Address - State:FL
Mailing Address - Zip Code:33550-1592
Mailing Address - Country:US
Mailing Address - Phone:813-708-2313
Mailing Address - Fax:
Practice Address - Street 1:6010 ATTICUS LN
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-7351
Practice Address - Country:US
Practice Address - Phone:813-708-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula