Provider Demographics
NPI:1417956582
Name:KARP, KENNETH O (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:O
Last Name:KARP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1951 SW 172ND AVE
Mailing Address - Street 2:304
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5593
Mailing Address - Country:US
Mailing Address - Phone:954-437-4316
Mailing Address - Fax:954-437-4352
Practice Address - Street 1:1951 SW 172ND AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5593
Practice Address - Country:US
Practice Address - Phone:954-437-4316
Practice Address - Fax:954-437-4352
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2016-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME78010207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259737302Medicaid
FL259737302Medicaid
FLG68843Medicare UPIN