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Individual

KATELYN VAN DE WATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CAA

Contact information

Practice address
2776 CLEVELAND AVE, FORT MYERS, FL 33901-5864
(239) 343-2000
Mailing address
14935 HAWKSMOOR RUN CIR, ORLANDO, FL 32828-7511

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA544
FL
367H00000X
Anesthesiologist Assistant

Other

Enumeration date
09/13/2019
Last updated
10/02/2019
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