MEDICARE: KAREN CECILIA ZACARIAS QUIJADA MD

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	208D00000X	General Practice Physician	R6600	KY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1780388355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN CECILIA ZACARIAS QUIJADA MD

Provider Business Mailing Address
First Line	:	327 E ESPLANADE AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40214-2836
Country	:	US
Telephone Number	:	513-630-7696
Fax Number	:

Provider Business Practice Location Address
First Line	:	4402 CHURCHMAN AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40215-1190
Country	:	US
Telephone Number	:	502-588-8720
Fax Number	:

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

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	01/13/2026

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