Provider Demographics
NPI:1326071069
Name:SEIBERT, KARLA (MD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CYPRESS WAY E STE 10
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-9275
Mailing Address - Country:US
Mailing Address - Phone:239-513-2489
Mailing Address - Fax:877-519-0822
Practice Address - Street 1:90 CYPRESS WAY E STE 10
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-9275
Practice Address - Country:US
Practice Address - Phone:239-513-2489
Practice Address - Fax:877-519-0822
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049682100Medicaid
FL03751XOtherMEDICARE ID PTAN EFFECTIVE DATE 5/1/2012
FL03751AOtherMEDICARE ID PTAN EFFECTIVE 2006
FL03751AOtherMEDICARE ID PTAN EFFECTIVE 2006