Theilade, Karen Christiane
Theilade, Karen Christiane is an individual health care provider with primary practice located at 120 Cypress Edge Dr Suite 203, Palm Coast FL 32164-8453. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Theilade, Karen Christiane can be contacted via phone (386) 586-4410.Contact Information
Primary practice address
120 Cypress Edge Dr Suite 203
Palm Coast FL 32164-8453
Phone: (386) 586-4410
Fax: (386) 445-3398
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ME106807 | Florida |
Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | ME106807 | Florida |
Profile Details
NPI number | 1750422184 |
---|---|
LBN Legal business name | Theilade, Karen Christiane |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 9th, 2007 |
Last updated | Sep 30th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1750422184 | NPPES |
Florida | Other | 14AA4 | BCBS |
Florida | MEDICAID | 003120001 | BCBS |
Florida | Other | P01170719 | BCBS |
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