Healthcare Provider Details

I. General information

NPI: 1376592147
Provider Name (Legal Business Name): SHERRY M KARNAVAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 03/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2866 TAMIAMI TRL STE A
PORT CHARLOTTE FL
33952-5165
US

IV. Provider business mailing address

128 GOLDEN GATE PT #502
SARASOTA FL
34236-6627
US

V. Phone/Fax

Practice location:
  • Phone: 941-764-1055
  • Fax:
Mailing address:
  • Phone: 941-955-8168
  • Fax: 941-764-7984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPA9103565
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: