Healthcare Provider Details

I. General information

NPI: 1487075008
Provider Name (Legal Business Name): CAITLIN N DAMMIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2013
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 S ORANGE AVE
ORLANDO FL
32806-1226
US

IV. Provider business mailing address

108 CANTERBURY PL
JUPITER FL
33458-6529
US

V. Phone/Fax

Practice location:
  • Phone: 941-444-0011
  • Fax: 603-952-3900
Mailing address:
  • Phone: 410-236-6995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number61073
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: