1386892289 NPI number — CATHY LEE AARON PA-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386892289 NPI number — CATHY LEE AARON PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AARON
Provider First Name:
CATHY
Provider Middle Name:
LEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORRIS
Provider Other First Name:
CATHY
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386892289
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1717 N E ST
Provider Second Line Business Mailing Address:
STE 331
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32501-6335
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-484-6500
Provider Business Mailing Address Fax Number:
850-857-1747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5147 N 9TH AVE STE 311
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32504-8770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-477-2597
Provider Business Practice Location Address Fax Number:
850-478-7941
Provider Enumeration Date:
09/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA837 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: PA9104685 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1386892289 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: AP130X . This is a "MCR PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Y00ZC . This is a "BCBS FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 000484200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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