Provider Demographics
NPI:1700218369
Name:SHERUBAWON, KARLA S (CRNA)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:S
Last Name:SHERUBAWON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:S
Other - Last Name:BECKFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2169 PLANTATION OAK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4869
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 N DEAN RD STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3710
Practice Address - Country:US
Practice Address - Phone:407-506-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9277236367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered