Healthcare Provider Details

I. General information

NPI: 1871661785
Provider Name (Legal Business Name): KAREN N MCGOUGH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S OSPREY AVE SUITE 1-A
SARASOTA FL
34239-2939
US

IV. Provider business mailing address

PO BOX 863407
ORLANDO FL
32886-0001
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-7197
  • Fax: 941-917-4016
Mailing address:
  • Phone: 941-917-2600
  • Fax: 941-917-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberARNP1933992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: