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General NPI Number Information
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NPI Number | 1306003678
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Entity Type | Individual
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Provider Name | KARLA MAARIT LODGE PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | LOYAL SOURCE GOVERNMENT SERVICES 12612 CHALLENGER PKWY #365
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City | ORLANDO
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State | FL
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Zip | 32826
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Country | US
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Telephone | 407-306-8441
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Fax | 888-316-1686
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Provider Business Mailing Address
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Address Line | PO BOX 2527
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City | SCOTTSDALE
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State | AZ
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Zip | 85252-2527
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Country | US
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Telephone | 602-703-3197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2427
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License Number State | AZ
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