Healthcare Provider Details

I. General information

NPI: 1548317290
Provider Name (Legal Business Name): KAREN FORSYTHE MONROE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2191 9TH AVE N SUITE 105
ST PETERSBURG FL
33713-7146
US

IV. Provider business mailing address

2191 9TH AVE N
SAINT PETERSBURG FL
33713-7146
US

V. Phone/Fax

Practice location:
  • Phone: 727-323-1090
  • Fax: 727-323-1010
Mailing address:
  • Phone: 727-323-1090
  • Fax: 727-323-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME89609
License Number StateFL

VIII. Authorized Official

Name: DR. KAREN FORSYTHE MONROE
Title or Position: OWNER
Credential: MD
Phone: 727-323-1090