MEDICARE: KAREN LYNN ZARRELLA PHD

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	103T00000X	Psychologist	PY0005609	FL

General Provider Information

NPI Number	:	1952350670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LYNN ZARRELLA PHD

Provider Business Mailing Address
First Line	:	3599 W LAKE MARY BLVD
Second Line	:	SUITE D
City	:	LAKE MARY
State	:	FL
Zip	:	32746-3417
Country	:	US
Telephone Number	:	407-330-3429
Fax Number	:	407-549-5603

Provider Business Practice Location Address
First Line	:	3599 W LAKE MARY BLVD
Second Line	:	SUITE D
City	:	LAKE MARY
State	:	FL
Zip	:	32746-3417
Country	:	US
Telephone Number	:	407-330-3429
Fax Number	:	407-549-5603

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	06/01/2012

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