=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952973778
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARINA NARCISA CASALETT ECFMG , N A, NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2021
-----------------------------------------------------
Last Update Date | 07/12/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | GALLO 1330 CABA
-----------------------------------------------------
City | C1425
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 1425C
-----------------------------------------------------
Country | AR
-----------------------------------------------------
Telephone | 786-327-3487
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9800 NW 51ST LN
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33178-3409
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-327-3487
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | 9265856
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------