Provider Demographics
NPI:1699822692
Name:GRIFFENKRANZ, KAREN PRICE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:PRICE
Last Name:GRIFFENKRANZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:P
Other - Last Name:SHARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3201 HIDDEN LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6317
Mailing Address - Country:US
Mailing Address - Phone:904-610-3875
Mailing Address - Fax:
Practice Address - Street 1:3311 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3704
Practice Address - Country:US
Practice Address - Phone:904-396-1462
Practice Address - Fax:904-396-1199
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL004499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL880339100Medicaid
FL44174OtherBLUE CROSS BLUE SHIELD