Provider Demographics
NPI:1609811843
Name:RENE, KARL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:
Last Name:RENE
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Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:3100 W END AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1320
Mailing Address - Country:US
Mailing Address - Phone:615-345-5400
Mailing Address - Fax:888-468-6511
Practice Address - Street 1:1600 SARNO RD
Practice Address - Street 2:SUITE 15
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4938
Practice Address - Country:US
Practice Address - Phone:800-348-4565
Practice Address - Fax:888-468-6511
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2016-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9102895363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q30935Medicare UPIN