Provider Demographics
NPI:1780975979
Name:CATALANO, DEANNA (RPH)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:CATALANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6631 ORION DR STE 112
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4333
Mailing Address - Country:US
Mailing Address - Phone:239-690-7700
Mailing Address - Fax:239-288-2578
Practice Address - Street 1:6631 ORION DR STE 112
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912
Practice Address - Country:US
Practice Address - Phone:239-690-7700
Practice Address - Fax:239-288-2578
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS41844OtherSTATE LICENSE