Provider Demographics
NPI:1225652266
Name:MELVANI, KAREN EILEEN (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EILEEN
Last Name:MELVANI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:EILEEN
Other - Last Name:PREMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1299 S OCEAN BLVD APT F3
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7730
Mailing Address - Country:US
Mailing Address - Phone:203-676-2800
Mailing Address - Fax:
Practice Address - Street 1:1299 S OCEAN BLVD APT F3
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7730
Practice Address - Country:US
Practice Address - Phone:203-676-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNP145025363LP2300X
FL11010310363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty