Provider Demographics
NPI:1568424083
Name:MCINTYRE, CATHERINE J (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:J
Last Name:MCINTYRE
Suffix:
Gender:F
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:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0333
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:836 PRUDENTIAL DR
Practice Address - Street 2:SUITE 1202
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8339
Practice Address - Country:US
Practice Address - Phone:904-399-4862
Practice Address - Fax:904-346-5410
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME78294207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373978300Medicaid
FL373978300Medicaid
FL46911XMedicare PIN