Provider Demographics
NPI:1982855680
Name:CATES-SMITH, PAMELA C (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:C
Last Name:CATES-SMITH
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 1:4401 S ORANGE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6934
Mailing Address - Country:US
Mailing Address - Phone:407-207-5717
Mailing Address - Fax:407-245-1423
Practice Address - Street 1:4401 S ORANGE AVE STE 108
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6934
Practice Address - Country:US
Practice Address - Phone:407-207-5717
Practice Address - Fax:407-245-1423
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104432207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001105200Medicaid
FL001105200Medicaid
BY482YMedicare PIN