Healthcare Provider Details

I. General information

NPI: 1194131284
Provider Name (Legal Business Name): KAREN CORNING D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 STATE ROAD 54
TRINITY FL
34655
US

IV. Provider business mailing address

5424 GRAND BLVD
NEW PORT RICHEY FL
34652-4008
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberUO4055
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: