Provider Demographics
NPI:1780981035
Name:BAESSO, KARINA D (DPM)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:D
Last Name:BAESSO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5103 SW 141ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5968
Mailing Address - Country:US
Mailing Address - Phone:954-907-2191
Mailing Address - Fax:305-829-5324
Practice Address - Street 1:3661 S MIAMI AVE STE 309
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4232
Practice Address - Country:US
Practice Address - Phone:305-854-6600
Practice Address - Fax:305-854-6602
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2012-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPO3466213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery