MEDICARE: DR. KARL MUELLER DO

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	207Q00000X	Family Medicine Physician	19904	FL

General Provider Information

NPI Number	:	1689203564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL MUELLER DO

Provider Business Mailing Address
First Line	:	201 LAGRANDE BLVD
Second Line	:
City	:	LADY LAKE
State	:	FL
Zip	:	32159-1303
Country	:	US
Telephone Number	:	352-753-0606
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 LAGRANDE BLVD
Second Line	:
City	:	LADY LAKE
State	:	FL
Zip	:	32159-1303
Country	:	US
Telephone Number	:	352-753-0606
Fax Number	:

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

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	09/25/2023

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