Provider Demographics
NPI:1679873640
Name:KARASOPOULOS, ROBIN (AUD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:KARASOPOULOS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 BRIARGATE PKWY
Mailing Address - Street 2:#125
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3480
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:4105 BRIARGATE PKWY
Practice Address - Street 2:#125
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3480
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0000395231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23309245Medicaid
CO026422OtherKAISER COMMERCIAL NUMBER
CO333183YXW3Medicare PIN
CO333183YNPJMedicare PIN
CO23309245Medicaid