Provider Demographics
NPI:1902368343
Name:JASCHKE, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JASCHKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:JASCHKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA12625
Mailing Address - Street 1:1206 SAINT TROPEZ CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5590
Mailing Address - Country:US
Mailing Address - Phone:407-325-9454
Mailing Address - Fax:
Practice Address - Street 1:1206 SAINT TROPEZ CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5590
Practice Address - Country:US
Practice Address - Phone:407-325-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA12625225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist