Healthcare Provider Details

I. General information

NPI: 1003478082
Provider Name (Legal Business Name): JOHANNA GUADALUPE CAMPOS CATALAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SE 17TH ST STE 600
OCALA FL
34471-4668
US

IV. Provider business mailing address

PO BOX 100296
GAINESVILLE FL
32610-0296
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-8955
  • Fax: 352-732-7999
Mailing address:
  • Phone: 352-627-9350
  • Fax: 352-273-9054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME154981
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: