Mathis, Karen Kelley

Mathis, Karen Kelley is an sole proprietor health care provider with primary practice located at 1354 State Road 60 E , Lake Wales FL 33853-4322. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Mathis, Karen Kelley can be contacted via phone (863) 679-8888.

Contact Information

Primary practice address
1354 State Road 60 E Lake Wales FL 33853-4322
Phone: (863) 679-8888
Fax: (863) 676-2851
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9103274 Florida

Profile Details

NPI number 1679504492
LBN Legal business name Mathis, Karen Kelley
Credentials PAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2006
Last updated Mar 5th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679504492 NPPES
Florida Other 1679504492 NPI
Florida MEDICAID 292213400 NPI

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