Provider Demographics
NPI:1972556892
Name:KENNETH O. KARP, MD, PA
Entity Type:Organization
Organization Name:KENNETH O. KARP, MD, PA
Other - Org Name:MIRAMAR EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:O
Authorized Official - Last Name:KARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-437-4316
Mailing Address - Street 1:1951 SW 172 AVE.
Mailing Address - Street 2:304
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029
Mailing Address - Country:US
Mailing Address - Phone:954-437-4316
Mailing Address - Fax:954-437-4352
Practice Address - Street 1:1951 SW 172 AVE.
Practice Address - Street 2:304
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:954-437-4316
Practice Address - Fax:954-437-4352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259737302Medicaid
FLG68843Medicare UPIN