Individual
DR. KAREN RONQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., M.D.
Contact information
Practice address
20611 WATERTOWN RD STE C, WAUKESHA, WI 53186-1871
(262) 333-3173
(262) 333-3173
Mailing address
300 E BROADWAY, WAUKESHA, WI 53187-3001
(414) 708-8852
(262) 364-3099
Taxonomy
Speciality
Code
Description
License number
State
2083C0008X
Clinical Informatics Physician
55146-20
WI
2083X0100X
Occupational Medicine Physician
Primary
55146-20
WI
208D00000X
General Practice Physician
55146-020
WI
208D00000X
General Practice Physician
ACN 378
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003237000
—
FL
01
—
ET905Z
MEDICARE PTAN
FL
Enumeration date
01/14/2011
Last updated
07/21/2022
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