Provider Demographics
NPI:1295142016
Name:PAPATHEODOROU, CATHERINE R (APRN)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:R
Last Name:PAPATHEODOROU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:R
Other - Last Name:MARIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4308 N HABANA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6316
Mailing Address - Country:US
Mailing Address - Phone:813-490-9495
Mailing Address - Fax:813-874-0099
Practice Address - Street 1:311 NOLAND DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5719
Practice Address - Country:US
Practice Address - Phone:813-654-8100
Practice Address - Fax:813-874-0099
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-14
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9476459207RI0200X
NJ26NJ00510200363LA2200X
FLAPRN9476459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty