Provider Demographics
NPI:1235718586
Name:CATAPANO-MAMONE, KAILEY MICHELE (MD)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:MICHELE
Last Name:CATAPANO-MAMONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:MICHELE
Other - Last Name:CATAPANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BOX 103204
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0001
Mailing Address - Country:US
Mailing Address - Phone:352-265-0651
Mailing Address - Fax:352-265-0153
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2304
Practice Address - Country:US
Practice Address - Phone:352-265-0651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME169165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program