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Organization
IRENE KARDASHIAN M.D. , P.A.
Active
Organization
IRENE KARDASHIAN M.D. , P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON LARSEN (OFFICE MANAGER)
(727) 819-2534
Entity
Organization
Contact information
Practice address
14100 FIVAY RD, SUITE 100, HUDSON, FL 34667-7180
(727) 819-2534
(727) 819-2687
Mailing address
14100 FIVAY RD, SUITE 100, HUDSON, FL 34667-7180
(727) 819-2534
(727) 819-2687
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME79368
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124011804
INDIVIDUAL NPI
FL
Enumeration date
03/26/2009
Last updated
06/22/2010
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