Provider Demographics
NPI:1710174990
Name:FAMILY TREE MEDICAL CARE PA
Entity Type:Organization
Organization Name:FAMILY TREE MEDICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALTOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-991-7320
Mailing Address - Street 1:2312 CRESTOVER LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6790
Mailing Address - Country:US
Mailing Address - Phone:813-991-7320
Mailing Address - Fax:813-991-7920
Practice Address - Street 1:2312 CRESTOVER LN
Practice Address - Street 2:SUITE 102
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6790
Practice Address - Country:US
Practice Address - Phone:813-991-7320
Practice Address - Fax:813-991-7920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96193261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care