Provider Demographics
NPI:1013909332
Name:KOWAL, CATHERINE NINA (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:NINA
Last Name:KOWAL
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 1:1855 VETERANS PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0446
Mailing Address - Country:US
Mailing Address - Phone:239-596-5220
Mailing Address - Fax:239-643-9816
Practice Address - Street 1:1855 VETERANS PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0446
Practice Address - Country:US
Practice Address - Phone:239-596-5220
Practice Address - Fax:239-643-9816
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2022-04-28
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
FLME62925207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373916300Medicaid
FL373916300Medicaid