Provider Demographics
NPI:1942327580
Name:CATALA, LEOPOLDO HENRIQUE (PA-C, MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:LEOPOLDO
Middle Name:HENRIQUE
Last Name:CATALA
Suffix:
Gender:M
Credentials:PA-C, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11801SW90TH ST 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2182
Mailing Address - Country:US
Mailing Address - Phone:305-595-1317
Mailing Address - Fax:305-279-6813
Practice Address - Street 1:1150 CAMPO SANO AVE STE 200
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1174
Practice Address - Country:US
Practice Address - Phone:786-268-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21362255A2300X
FLPA9108119363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer