Healthcare Provider Details

I. General information

NPI: 1104650092
Provider Name (Legal Business Name): KARLA CECILIA SESSKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14851 LYONS RD # 106B
DELRAY BEACH FL
33446-9010
US

IV. Provider business mailing address

6809 MOONLIT DR
DELRAY BEACH FL
33446-1631
US

V. Phone/Fax

Practice location:
  • Phone: 516-468-4256
  • Fax:
Mailing address:
  • Phone: 516-468-4256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number50-44-1902546
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: