Provider Demographics
NPI:1457341422
Name:HAMAD, KAREN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MARIE
Last Name:HAMAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:929 S TAMIAMI TRL
Practice Address - Street 2:101
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9239
Practice Address - Country:US
Practice Address - Phone:941-917-4700
Practice Address - Fax:941-917-4710
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88051208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267585400Medicaid
FLP00210729OtherMEDICARE RAILROAD
FL71286OtherBCBS
FL71286ZMedicare PIN
FLG96171Medicare UPIN