=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578991857
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAR MEDICAL CONSULTANTS, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2013
-----------------------------------------------------
Last Update Date | 10/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13660 JOG RD STE 6
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33446-3806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-272-8991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 285 SE 5TH AVE
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33483-5206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-272-8991
-----------------------------------------------------
Fax | 561-272-8985
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | DR. KAREN FAYE KUHNS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 561-350-6302
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | ME80414
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------