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General NPI Number Information
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NPI Number | 1780210682
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Entity Type | Individual
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Provider Name | KATELYN PETITFILS JOUBERT DO
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 6201 W NEWBERRY RD
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City | GAINESVILLE
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State | FL
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Zip | 32605-4305
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Country | US
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Telephone | 352-265-2020
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Fax | 352-627-4299
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Provider Business Mailing Address
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Address Line | 112 SOHO CIR
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City | LAFAYETTE
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State | LA
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Zip | 70508-4200
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Country | US
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Telephone | 337-349-4616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS21123
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License Number State | FL
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