Provider Demographics
NPI:1952668667
Name:MOSQUERA, CATALINA (MD)
Entity Type:Individual
Prefix:
First Name:CATALINA
Middle Name:
Last Name:MOSQUERA
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 1:3232 BROOK RD APT 111
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227
Mailing Address - Country:US
Mailing Address - Phone:781-640-0913
Mailing Address - Fax:804-828-5613
Practice Address - Street 1:2270 COLONIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORTMYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:239-938-9384
Practice Address - Fax:804-828-5613
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250629208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery