Healthcare Provider Details

I. General information

NPI: 1497614523
Provider Name (Legal Business Name): KARSON KEIBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 E ALTAMONTE DR STE 210
ALTAMONTE SPRINGS FL
32701
US

IV. Provider business mailing address

711 E ALTAMONTE DR STE 210
ALTAMONTE SPRINGS FL
32701
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5452
  • Fax: 407-303-5448
Mailing address:
  • Phone: 407-303-5452
  • Fax: 407-303-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: