Provider Demographics
NPI:1518313543
Name:BARKDOLL, KARLA (LMT)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:BARKDOLL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1754 BOCAWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4908
Mailing Address - Country:US
Mailing Address - Phone:727-372-6389
Mailing Address - Fax:
Practice Address - Street 1:1754 BOCAWOOD CT
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4908
Practice Address - Country:US
Practice Address - Phone:727-372-6389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA47546174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist