Provider Demographics
NPI:1801820493
Name:LOE, CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:LOE
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 1:15502 STONEYBROOK WEST PKWY
Mailing Address - Street 2:SUITE 2-108
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4767
Mailing Address - Country:US
Mailing Address - Phone:407-656-0042
Mailing Address - Fax:
Practice Address - Street 1:15502 STONEYBROOK WEST PKWY
Practice Address - Street 2:SUITE 2-108
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4767
Practice Address - Country:US
Practice Address - Phone:407-656-0042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 113432208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1351555Medicaid
LAB62215Medicare UPIN
LA4M722C822Medicare PIN
LA4E767C822Medicare PIN