Provider Demographics
NPI:1437806288
Name:CAMPOS, KAREN (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15761 SW 102ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1521
Mailing Address - Country:US
Mailing Address - Phone:305-804-7598
Mailing Address - Fax:
Practice Address - Street 1:7000 SW 97TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1474
Practice Address - Country:US
Practice Address - Phone:786-299-5419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016074363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty