Provider Demographics
NPI:1568624807
Name:KOENIG, KARLI RENEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KARLI
Middle Name:RENEE
Last Name:KOENIG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KARLI
Other - Middle Name:RENEE
Other - Last Name:OPPENBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:13020 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0915
Mailing Address - Country:US
Mailing Address - Phone:813-978-9700
Mailing Address - Fax:
Practice Address - Street 1:2044 TRINITY OAKS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4405
Practice Address - Country:US
Practice Address - Phone:727-461-6026
Practice Address - Fax:813-558-6044
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1182322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist