Provider Demographics
NPI:1871614909
Name:CATALANO, DAVID JOHN (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:CATALANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 ROLLING ACRES RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-5036
Mailing Address - Country:US
Mailing Address - Phone:352-674-6300
Mailing Address - Fax:352-753-6399
Practice Address - Street 1:922 ROLLING ACRES RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-5036
Practice Address - Country:US
Practice Address - Phone:352-674-6300
Practice Address - Fax:352-753-6399
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1016772085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000270100Medicaid
FLME101677OtherMEDICAL LICENCE
FLAM336VMedicare UPIN
OR013388Medicaid