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General NPI Number Information
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NPI Number | 1972397016
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Entity Type | Individual
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Provider Name | KARINA OGANEZOVA
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Gender | Female
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 703 N FLAMINGO RD FL 2
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1006
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Country | US
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Telephone | 917-494-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 19195 MYSTIC POINTE DR PH 3
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City | AVENTURA
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State | FL
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Zip | 33180-4511
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Country | US
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Telephone | 917-494-9944
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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