Provider Demographics
NPI:1528598067
Name:BARTON, CATHERINE JESSICA (PA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JESSICA
Last Name:BARTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 RIVENDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-6817
Mailing Address - Country:US
Mailing Address - Phone:184-570-2751
Mailing Address - Fax:
Practice Address - Street 1:3357 W VINE ST STE 303
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4664
Practice Address - Country:US
Practice Address - Phone:407-962-7449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9112241363A00000X
NY020842363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant