Provider Demographics
NPI:1932291614
Name:KARL, MITCHELL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:KARL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:880 NW 13TH ST
Mailing Address - Street 2:STE 1B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486
Mailing Address - Country:US
Mailing Address - Phone:561-392-9214
Mailing Address - Fax:561-394-4250
Practice Address - Street 1:880 NW 13TH ST
Practice Address - Street 2:STE 1B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-392-9214
Practice Address - Fax:561-394-4250
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50027207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060056369Medicaid
10180Medicare ID - Type Unspecified
FL060056369Medicaid