MEDICARE: CATRINA M HAJAL 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	APRN11010301	FL
2	363LF0000X	Family Nurse Practitioner	11010301	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962008532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATRINA M HAJAL APRN

Provider Business Mailing Address
First Line	:	4500 NEWBERRY RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-2245
Country	:	US
Telephone Number	:	352-336-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4325 NE 138TH PL
Second Line	:
City	:	ANTHONY
State	:	FL
Zip	:	32617-2365
Country	:	US
Telephone Number	:	352-812-7875
Fax Number	:

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

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	11/28/2022

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