Provider Demographics
NPI:1679666770
Name:LAAUWE, KAREN LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNNE
Last Name:LAAUWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 NW 137 DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2658
Mailing Address - Country:US
Mailing Address - Phone:352-332-1890
Mailing Address - Fax:352-224-6465
Practice Address - Street 1:128 NW 137 DR
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-2658
Practice Address - Country:US
Practice Address - Phone:352-332-1890
Practice Address - Fax:352-224-6465
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86303207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265843700Medicaid
FL265843700Medicaid
FL62877YMedicare ID - Type Unspecified
G02871Medicare UPIN