| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KATHERINE CLARICE VITELLO | 1285366690 | 2022-06-26 |
Katherine Clarice Vitello is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1285366690. Registration indicates Katherine Clarice Vitello is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Katherine Clarice Vitello |
| Practice Office Address | 505 S NOLEN DR SOUTHLAKE, TX US |
| Practice Office Telephone | 8176970253 |
| Mailing Address | PO BOX 917770 ORLANDO, FL 328910001 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2 Tampa General Cir | Tampa, FL 336063571 | 8138218038 |
| Direct Messaging Address [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers |