Provider Demographics
NPI:1750170791
Name:KATTI, CHAFIC
Entity type:Individual
Prefix:
First Name:CHAFIC
Middle Name:
Last Name:KATTI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12116 MARGARITA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-1176
Mailing Address - Country:US
Mailing Address - Phone:323-600-4107
Mailing Address - Fax:
Practice Address - Street 1:4090 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5079
Practice Address - Country:US
Practice Address - Phone:941-493-6882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS68671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist