Provider Demographics
NPI:1235213323
Name:FLORIE, KARL (PT)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:FLORIE
Suffix:
Gender:M
Credentials:PT
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 212
Mailing Address - Street 2:
Mailing Address - City:KOPPEL
Mailing Address - State:PA
Mailing Address - Zip Code:16136-0212
Mailing Address - Country:US
Mailing Address - Phone:724-544-7270
Mailing Address - Fax:
Practice Address - Street 1:3410 4TH AVE STE B
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-3574
Practice Address - Country:US
Practice Address - Phone:724-544-7270
Practice Address - Fax:724-241-3716
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT001327208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA637304OtherHIGHMARK
PA0018453790003Medicaid
PA0018453790003Medicaid