Provider Demographics
NPI:1033212642
Name:COLWELL, KAREN JANE (MA OTRL CLT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JANE
Last Name:COLWELL
Suffix:
Gender:F
Credentials:MA OTRL CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAMPTON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-744-8500
Mailing Address - Fax:561-744-6152
Practice Address - Street 1:210 JUPITER LAKES BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-741-1876
Practice Address - Fax:561-741-1877
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT6594225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA509Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER