Provider Demographics
NPI:1194102285
Name:CATALYST WALK-IN CLINIC
Entity type:Organization
Organization Name:CATALYST WALK-IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SOHAAN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CHICHESTER-SHEPPERD
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:863-448-9242
Mailing Address - Street 1:1707 EAST OAK STREET
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266
Mailing Address - Country:US
Mailing Address - Phone:863-448-9242
Mailing Address - Fax:863-491-0760
Practice Address - Street 1:1707 EAST OAK STREET
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266
Practice Address - Country:US
Practice Address - Phone:863-448-9242
Practice Address - Fax:863-491-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center