Healthcare Provider Details

I. General information

NPI: 1083603112
Provider Name (Legal Business Name): KATIE M FALCO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 SE 32ND AVE
OCALA FL
34471-5532
US

IV. Provider business mailing address

15725 SE 47TH AVE
SUMMERFIELD FL
34491-5103
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-0137
  • Fax: 352-694-4824
Mailing address:
  • Phone: 352-629-0137
  • Fax: 352-694-4824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP2165402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: