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Individual

DR. KATERINA ANGELIQUE BACKUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2501 N ORANGE AVE, UNIT 514, ORLANDO, FL 32804-4603
(407) 303-5687
(407) 303-0806
Mailing address
2501 N ORANGE AVE, UNIT 514, ORLANDO, FL 32804-4603
(407) 303-5687
(407) 303-0806

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME98967
FL
2080S0010X
Pediatric Sports Medicine Physician
Primary
ME98967
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279148000
FL
Enumeration date
08/08/2007
Last updated
12/04/2020
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