Catherine Evangelista Aguaviva, APRN

Individual provider Active NPI Family Nurse Practitioner · Gainesville, FL

NPI 1417675562 · NPPES record last updated Nov 7, 2024

Key facts

NPI
1417675562
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
11020108 (FL)
Practice address
1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone
(352) 376-1611
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11020108FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11020108 FL Yes

Addresses

Primary practice location

1601 SW Archer Rd
Gainesville, FL 32608-1135

Mailing address

1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone (210) 748-5443

Other providers in Gainesville, FL

All providers in Gainesville, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.