Provider Demographics
NPI:1790089035
Name:PARADISO, CATHERINE C (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:C
Last Name:PARADISO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25097 OLYMPIA AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3912
Mailing Address - Country:US
Mailing Address - Phone:941-347-8341
Mailing Address - Fax:
Practice Address - Street 1:25097 OLYMPIA AVE STE 205
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3912
Practice Address - Country:US
Practice Address - Phone:941-637-5777
Practice Address - Fax:941-347-7702
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9235068363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11068500Medicaid