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General NPI Number Information
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NPI Number | 1194102285
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Entity Type | Organization
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Legal Business Name | CATALYST WALK-IN CLINIC
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 1707 EAST OAK STREET
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City | ARCADIA
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State | FL
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Zip | 34266
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Country | US
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Telephone | 863-448-9242
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Fax | 863-491-0760
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Provider Business Mailing Address
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Address Line | 1707 EAST OAK STREET
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City | ARCADIA
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State | FL
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Zip | 34266
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Country | US
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Telephone | 863-448-9242
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Fax | 863-491-0760
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | SOHAAN ANDREW CHICHESTER-SHEPPERD
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Credential | PA
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Telephone | 863-448-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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