Healthcare Provider Details
I. General information
NPI: 1285258566
Provider Name (Legal Business Name): CATALINA RESTREPO LOPERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/03/2020
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date: 01/18/2022
Reactivation Date: 04/18/2023
III. Provider practice location address
1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US
IV. Provider business mailing address
PO BOX 100374
GAINESVILLE FL
32610-0374
US
V. Phone/Fax
- Phone: 352-265-0291
- Fax:
- Phone: 352-265-0291
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | MFC1944 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: