Provider Demographics
NPI:1407994502
Name:FOUCHE, KAREN LORFANO (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LORFANO
Last Name:FOUCHE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12224 NOBLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-5541
Mailing Address - Country:US
Mailing Address - Phone:904-260-6059
Mailing Address - Fax:
Practice Address - Street 1:550 WELLS RD STE 4
Practice Address - Street 2:BROOKS REHABILITATION
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-2950
Practice Address - Country:US
Practice Address - Phone:904-278-7890
Practice Address - Fax:904-278-7762
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist