Provider Demographics
NPI:1407854789
Name:KARO, STEVEN L (PAC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:L
Last Name:KARO
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:19531 COCHRAN BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-2081
Practice Address - Country:US
Practice Address - Phone:941-255-3535
Practice Address - Fax:941-766-7999
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI833363AM0700X
MN8884363AM0700X
FLPA9107839363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42958900Medicaid
970026422OtherPALMETTO GBA RR MEDICARE
46Q69KAOtherBCBS MN
1009732OtherPREFERRED ONE
1009732OtherPREFERRED ONE
WIR68591Medicare UPIN