Provider Demographics
NPI:1679250898
Name:KARO, MARYAM LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:LOUIS
Last Name:KARO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11526 VIA LUCERNA CIR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6076
Mailing Address - Country:US
Mailing Address - Phone:586-863-8181
Mailing Address - Fax:
Practice Address - Street 1:106 LEE ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4913
Practice Address - Country:US
Practice Address - Phone:352-604-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN284451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice