Provider Demographics
NPI:1659341139
Name:DREHOBL, KARL E (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:E
Last Name:DREHOBL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 SE CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3904
Mailing Address - Country:US
Mailing Address - Phone:772-220-1391
Mailing Address - Fax:772-220-4087
Practice Address - Street 1:300 SE HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2338
Practice Address - Country:US
Practice Address - Phone:772-220-1391
Practice Address - Fax:772-220-4087
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME673002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251027800Medicaid
FL32331SMedicare PIN
FL32331SMedicare ID - Type Unspecified
FL251027800Medicaid