Provider Demographics
NPI:1083043053
Name:PATEL, KAREN (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2252
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-2252
Mailing Address - Country:US
Mailing Address - Phone:407-240-0004
Mailing Address - Fax:407-240-1114
Practice Address - Street 1:11955 S ORANGE BLOSSOM TRL
Practice Address - Street 2:SUITE 598
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-9252
Practice Address - Country:US
Practice Address - Phone:407-240-0004
Practice Address - Fax:407-240-1114
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 1398382163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN1398382OtherPRI-MED