Provider Demographics
NPI:1982020566
Name:RATHGEBER, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:RATHGEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 FORT SUMTER ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8359
Mailing Address - Country:US
Mailing Address - Phone:321-223-8567
Mailing Address - Fax:
Practice Address - Street 1:8584 EDEN ISLES LN
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-6800
Practice Address - Country:US
Practice Address - Phone:321-795-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1718225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist