Healthcare Provider Details

I. General information

NPI: 1700895232
Provider Name (Legal Business Name): KAREN HARKAVY TOKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 OAKBROOK CT
PONTE VEDRA BEACH FL
32082-2052
US

IV. Provider business mailing address

6030 OAKBROOK CT
PONTE VEDRA BEACH FL
32082-2052
US

V. Phone/Fax

Practice location:
  • Phone: 904-285-6851
  • Fax: 904-285-5112
Mailing address:
  • Phone: 904-285-6851
  • Fax: 904-285-5112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME58356
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: