Provider Demographics
NPI:1780915108
Name:MASSEY, KAREN (AP, DOM)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12529 DARBY AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8577
Mailing Address - Country:US
Mailing Address - Phone:407-443-1514
Mailing Address - Fax:
Practice Address - Street 1:12529 DARBY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8577
Practice Address - Country:US
Practice Address - Phone:407-443-1514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2721171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist