=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487276416
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATALINA MEDICAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2020
-----------------------------------------------------
Last Update Date | 05/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1304 E ATLANTIC BLVD STE C
-----------------------------------------------------
City | POMPANO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33060-6789
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 754-367-7634
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6368 NW 107TH TER
-----------------------------------------------------
City | PARKLAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33076-3762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-415-5202
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CATALINA BATTAGLIOLA
-----------------------------------------------------
Credential | CCPA
-----------------------------------------------------
Telephone | 754-367-7634
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------