Provider Demographics
NPI:1881720589
Name:KOENIG, KARL ROBERT (MSN-APRN-BC)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:ROBERT
Last Name:KOENIG
Suffix:
Gender:M
Credentials:MSN-APRN-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12103 KAY DR
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-2618
Mailing Address - Country:US
Mailing Address - Phone:727-319-0228
Mailing Address - Fax:727-319-1368
Practice Address - Street 1:10000 BAY PINES BLVD.
Practice Address - Street 2:116-A
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-5005
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-319-1368
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 9228941363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health