Healthcare Provider Details

I. General information

NPI: 1871614909
Provider Name (Legal Business Name): DAVID JOHN CATALANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 ROLLING ACRES RD SUITE 1
LADY LAKE FL
32159-5036
US

IV. Provider business mailing address

922 ROLLING ACRES RD SUITE 1
LADY LAKE FL
32159-5036
US

V. Phone/Fax

Practice location:
  • Phone: 352-674-6300
  • Fax: 352-753-6399
Mailing address:
  • Phone: 352-674-6300
  • Fax: 352-753-6399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME101677
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: