Provider Demographics
NPI:1114122561
Name:WALDROP, KAREN M (SLP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:WALDROP
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6039 COLLINS AVENUE
Mailing Address - Street 2:STE 811
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2251
Mailing Address - Country:US
Mailing Address - Phone:954-599-4185
Mailing Address - Fax:800-697-1979
Practice Address - Street 1:437 W. 41ST STREET
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2251
Practice Address - Country:US
Practice Address - Phone:954-599-4185
Practice Address - Fax:800-697-1979
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-17
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886744500Medicaid
FL015901500Medicaid