Provider Demographics
NPI:1689828204
Name:ABDUL M KARIM PA
Entity type:Organization
Organization Name:ABDUL M KARIM PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:E
Authorized Official - Last Name:NETTLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-806-3949
Mailing Address - Street 1:389 COMMERCE PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4202
Mailing Address - Country:US
Mailing Address - Phone:321-806-3949
Mailing Address - Fax:321-806-3945
Practice Address - Street 1:389 COMMERCE PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-4202
Practice Address - Country:US
Practice Address - Phone:321-806-3949
Practice Address - Fax:321-806-3945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty