Healthcare Provider Details
I. General information
NPI: 1346406865
Provider Name (Legal Business Name): CATHERINE MICHELLE KOWALSKI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/04/2008
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 36TH ST
VERO BEACH FL
32960-4862
US
IV. Provider business mailing address
3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US
V. Phone/Fax
- Phone: 772-567-4311
- Fax:
- Phone: 321-434-1771
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 010474 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | OS19788 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | OS19788 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: