MEDICARE: MS. KATRINA HARAVATA APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	11017766	FL

General Provider Information

NPI Number	:	1427639988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATRINA HARAVATA APRN

Provider Business Mailing Address
First Line	:	144 EAST AVE APT B303
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-5762
Country	:	US
Telephone Number	:	203-521-7584
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3504
Country	:	US
Telephone Number	:	561-530-2092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2021
Last Update Date	:	03/18/2026

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