Healthcare Provider Details

I. General information

NPI: 1982628632
Provider Name (Legal Business Name): KATHERYN E SARANTOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4627 NW 53RD AVE
GAINESVILLE FL
32606-4357
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 352-335-8888
  • Fax: 352-335-9427
Mailing address:
  • Phone: 352-335-8888
  • Fax: 352-335-9427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME64047
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: