Healthcare Provider Details

I. General information

NPI: 1235718586
Provider Name (Legal Business Name): KAILEY MICHELE CATAPANO-MAMONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAILEY MICHELE CATAPANO

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-2304
US

IV. Provider business mailing address

BOX 103204
GAINESVILLE FL
32610-0001
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0651
  • Fax:
Mailing address:
  • Phone: 352-265-0651
  • Fax: 352-265-0153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME169165
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: