Basic Information
| Provider Information | |||||||||
| NPI: | 1023581634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NORTON | ||||||||
| FirstName: | KATARINA | ||||||||
| MiddleName: | ELAINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3197 FOX SQUIRREL DR | ||||||||
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| City: | ORANGE PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320732246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9047425841 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3495 HOFFMAN ST, PENNEY FARMS, FL 32079 | ||||||||
| Address2: | |||||||||
| City: | PENNEY FARMS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003852527 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2019 | ||||||||
| LastUpdateDate: | 01/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PTA26361 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.