Provider Demographics
NPI:1538132949
Name:PAFUNDA, KATHERINE CARTWRIGHT (AUD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CARTWRIGHT
Last Name:PAFUNDA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KC
Other - Middle Name:
Other - Last Name:PAFUNDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 95004
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33804-5004
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:863-680-7420
Practice Address - Street 1:1755 N. FLORIDA AVENUE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3109
Practice Address - Country:US
Practice Address - Phone:863-904-6200
Practice Address - Fax:863-904-6280
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY48231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000307400Medicaid
FL000307400Medicaid