1679029193 NPI number — KAREN WOLMAN, PSY.D.

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 1679029193 NPI number — KAREN WOLMAN, PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAREN WOLMAN, PSY.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679029193
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2363
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDERMERE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34786-2363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-493-4045
Provider Business Mailing Address Fax Number:
918-401-8648

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6645 VINELAND RD
Provider Second Line Business Practice Location Address:
SUITE 270
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32819-7841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-493-4045
Provider Business Practice Location Address Fax Number:
918-401-8648
Provider Enumeration Date:
08/26/2016

Additional Information

Authorized Official

Authorized Official Last Name:
WOLMAN
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
407-493-4045

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PY6288 , 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)





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