Healthcare Provider Details

I. General information

NPI: 1063486132
Provider Name (Legal Business Name): KARL A HEBBE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 PARK AVE SUITE 202
SOUTH PLAINFIELD NJ
07080-5530
US

IV. Provider business mailing address

1825 NW CORPORATE BLVD STE 105
BOCA RATON FL
33431-8554
US

V. Phone/Fax

Practice location:
  • Phone: 908-561-1313
  • Fax: 908-561-3917
Mailing address:
  • Phone: 561-299-3667
  • Fax: 561-299-3670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMB68516
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MB06851600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2016-02413
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberOS14248
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: