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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750422184 NPPES
Florida Other 14AA4 BCBS
Florida MEDICAID 003120001 BCBS
Florida Other P01170719 BCBS

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