Provider Demographics
NPI:1780786582
Name:O'CONNELL, CATHERINE M (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:M
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2947 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-7113
Mailing Address - Country:US
Mailing Address - Phone:941-954-1123
Mailing Address - Fax:941-954-1173
Practice Address - Street 1:2947 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7113
Practice Address - Country:US
Practice Address - Phone:941-954-1123
Practice Address - Fax:941-954-1173
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME58455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080162742OtherMEDICARE RR
FL11494OtherBCBS OF FL
FL650993583OtherTAX ID
FLAB286ZMedicare PIN
FL080162742OtherMEDICARE RR