Healthcare Provider Details

I. General information

NPI: 1609130137
Provider Name (Legal Business Name): CATALINA CABRERA-SALCEDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E CHESTNUT ST
LOUISVILLE KY
40202
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-588-3400
  • Fax: 502-588-3401
Mailing address:
  • Phone: 502-588-3400
  • Fax: 502-588-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number51298
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number51298
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: