1952973778 NPI number — KARINA NARCISA CASALETT ECFMG , N A, NP

Table of content: KARINA NARCISA CASALETT ECFMG , N A, NP (NPI 1952973778)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952973778 NPI number — KARINA NARCISA CASALETT ECFMG , N A, NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASALETT
Provider First Name:
KARINA
Provider Middle Name:
NARCISA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ECFMG , N A, NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CASALETT
Provider Other First Name:
KARINA
Provider Other Middle Name:
NARCISA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NA, NP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1952973778
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9800 NW 51ST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DORAL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33178-3409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-327-3487
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GALLO 1330
Provider Second Line Business Practice Location Address:
CABA
Provider Business Practice Location Address City Name:
C1425
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
1425C
Provider Business Practice Location Address Country Code:
AR
Provider Business Practice Location Address Telephone Number:
786-327-3487
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2021

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: 164W00000X , with the licence number:  9265856 , 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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