Provider Demographics
NPI:1083975726
Name:MULITALO, KAREN ESETA (MPAS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ESETA
Last Name:MULITALO
Suffix:
Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:2530 NW 34TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-2615
Mailing Address - Country:US
Mailing Address - Phone:352-672-1867
Mailing Address - Fax:
Practice Address - Street 1:1329 SW 16TH ST
Practice Address - Street 2:SUITE 1160
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1128
Practice Address - Country:US
Practice Address - Phone:352-265-7955
Practice Address - Fax:352-265-7210
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT327164-1206363AM0700X
TXPS04308363AM0700X
FLPA9106217363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical