Provider Demographics
NPI:1972397016
Name:OGANEZOVA, KARINA
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:OGANEZOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19195 MYSTIC POINTE DR PH 3
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4511
Mailing Address - Country:US
Mailing Address - Phone:917-494-9944
Mailing Address - Fax:
Practice Address - Street 1:703 N FLAMINGO RD FL 2
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1006
Practice Address - Country:US
Practice Address - Phone:917-494-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program