Healthcare Provider Details

I. General information

NPI: 1063718898
Provider Name (Legal Business Name): KAREN B SCHICK, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S FLORIDA AVE #6
LAKELAND FL
33801-5237
US

IV. Provider business mailing address

601 S FLORIDA AVE #6
LAKELAND FL
33801-5237
US

V. Phone/Fax

Practice location:
  • Phone: 863-688-0841
  • Fax: 863-616-9709
Mailing address:
  • Phone: 863-688-0841
  • Fax: 863-616-9709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME42239
License Number StateFL

VIII. Authorized Official

Name: DR. KAREN BETH SCHICK
Title or Position: OWNER
Credential: MD
Phone: 863-688-0841