Healthcare Provider Details

I. General information

NPI: 1215723689
Provider Name (Legal Business Name): KATRINA PATRESE CASZATT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 BOATNER ROAD SUITE 114
EGLIN AFB FL
32542
US

IV. Provider business mailing address

307 BOATNER ROAD SUITE 114
EGLIN AFB FL
32542
US

V. Phone/Fax

Practice location:
  • Phone: 850-883-8655
  • Fax:
Mailing address:
  • Phone: 850-883-8655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME183755
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: