Provider Demographics
NPI:1548616378
Name:AREVALO, CATHERINE M (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:AREVALO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:URICOECHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:115 E LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-6689
Mailing Address - Country:US
Mailing Address - Phone:407-680-2273
Mailing Address - Fax:321-274-0224
Practice Address - Street 1:115 E LANCASTER RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-6689
Practice Address - Country:US
Practice Address - Phone:407-378-6686
Practice Address - Fax:407-378-4633
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1005208D00000X, 207P00000X
PR019315282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care Hospital