Provider Demographics
NPI:1790846756
Name:KARIM, ABDUL (MD)
Entity Type:Individual
Prefix:
First Name:ABDUL
Middle Name:
Last Name:KARIM
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 1:389 COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4202
Mailing Address - Country:US
Mailing Address - Phone:321-806-3949
Mailing Address - Fax:321-806-3945
Practice Address - Street 1:389 COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-4202
Practice Address - Country:US
Practice Address - Phone:321-806-3949
Practice Address - Fax:321-806-3945
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46164207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27884OtherWELLCARE
FL05583OtherBCBC FL
FL05583ZMedicare ID - Type Unspecified
FL27884OtherWELLCARE