Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME142884 | FL |
NPI | 1013208453 |
---|---|
Provider Name | Karen Leonia Walker |
First Address | Orlando, FL 32806-1215 |
Second Address | Orlando, FL 32806-1215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2011 |
Last Update Date | 18/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104757600 | (05) | FL |