Provider Demographics
NPI:1205936739
Name:VOLKMANN, KAREN LEE (MSPT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:VOLKMANN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5762
Mailing Address - Country:US
Mailing Address - Phone:863-802-3800
Mailing Address - Fax:863-802-0480
Practice Address - Street 1:1215 E ORANGE ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5762
Practice Address - Country:US
Practice Address - Phone:863-802-3800
Practice Address - Fax:863-802-0480
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 0003085225100000X
FLPT3085222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL882092900Medicaid
FL13424701OtherCITRUS HEALTHCARE INS
FLPT0003085OtherPT LICENSE
FLY905LOtherBCBS OF FL