Individual
MRS. KAREN ELIZABETH MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5275 SW 133RD AVE, MIAMI, FL 33175-5231
(305) 227-4209
(305) 227-4209
Mailing address
5275 SW 133RD AVE, MIAMI, FL 33175-5231
(305) 227-4209
(305) 227-4209
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
KHU-0108-688-84
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300096600
—
FL
Enumeration date
05/20/2008
Last updated
05/20/2008
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