1457375818 NPI number — MS. KAREN R DEES ARNP

Table of content: MS. KAREN R DEES ARNP (NPI 1457375818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457375818 NPI number — MS. KAREN R DEES ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEES
Provider First Name:
KAREN
Provider Middle Name:
R
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEES
Provider Other First Name:
KAREN
Provider Other Middle Name:
RAE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457375818
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 918025
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32891-8025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-392-4195
Provider Business Mailing Address Fax Number:
352-392-4533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 SW ARCHER RD
Provider Second Line Business Practice Location Address:
BOX 100371
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32610-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-392-4195
Provider Business Practice Location Address Fax Number:
352-392-4533
Provider Enumeration Date:
07/27/2006

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: 363LN0000X , with the licence number:  ARNP1648112 , 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: 302072000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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