Provider Demographics
NPI:1063486132
Name:HEBBE, KARL A (DO)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:A
Last Name:HEBBE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 NW CORPORATE BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8554
Mailing Address - Country:US
Mailing Address - Phone:561-299-3667
Mailing Address - Fax:561-299-3670
Practice Address - Street 1:1907 PARK AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5530
Practice Address - Country:US
Practice Address - Phone:908-561-1313
Practice Address - Fax:908-561-3917
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB68516207RP1001X
NJ25MB06851600207RC0200X
NC2016-02413207RC0200X
FLOS14248207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2K4729OtherHEALTHNET
NJ8231508Medicaid
NJP00091589OtherRAILROAD MEDICARE
NJP3209508OtherOXFORD
NJ2355365000OtherAMERIHEALTH
NJ4668858OtherCIGNA
NJ2K4729OtherHEALTHNET
NJ4668858OtherCIGNA