Provider Demographics
NPI:1033439195
Name:MARTIN, KAREN YVONNE (OPTICIAN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:YVONNE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 S TAMIAMI TRL
Mailing Address - Street 2:STE 98
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-7004
Mailing Address - Country:US
Mailing Address - Phone:941-809-9882
Mailing Address - Fax:
Practice Address - Street 1:1219 S EAST AVE
Practice Address - Street 2:STE 107
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2340
Practice Address - Country:US
Practice Address - Phone:941-365-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1670156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician