Provider Demographics
NPI:1376634220
Name:CATALFUMO, FRANK JOHN (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOHN
Last Name:CATALFUMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S SHORE RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9119
Mailing Address - Country:US
Mailing Address - Phone:772-337-3675
Mailing Address - Fax:
Practice Address - Street 1:410 SE HIBISCUS AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-2550
Practice Address - Country:US
Practice Address - Phone:772-283-0226
Practice Address - Fax:772-283-0480
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84727174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE40332Medicare UPIN
185937MVLMedicare ID - Type Unspecified