Provider Demographics
NPI:1376145227
Name:URQUHART, KARINA M (LMT)
Entity Type:Individual
Prefix:MISS
First Name:KARINA
Middle Name:M
Last Name:URQUHART
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:MONTSERRAT
Other - Last Name:URQUHART VILLALBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:11025 PONDVIEW DR APT B
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6028
Mailing Address - Country:US
Mailing Address - Phone:407-283-9636
Mailing Address - Fax:
Practice Address - Street 1:11025 PONDVIEW DR APT B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-6028
Practice Address - Country:US
Practice Address - Phone:407-283-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA60240225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist