MEDICARE: HABIB H. KARKAVANDIAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	OS8158	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003869504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HABIB H. KARKAVANDIAN D.O.

Provider Business Mailing Address
First Line	:	8810 CAMERON CREST DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-4712
Country	:	US
Telephone Number	:	303-249-2529
Fax Number	:

Provider Business Practice Location Address
First Line	:	12187 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1732
Country	:	US
Telephone Number	:	813-814-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	03/04/2017

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