Provider Demographics
NPI:1104329127
Name:DEAN, KARIM ROCIO
Entity type:Individual
Prefix:
First Name:KARIM
Middle Name:ROCIO
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 FARM BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-7074
Mailing Address - Country:US
Mailing Address - Phone:786-650-6034
Mailing Address - Fax:
Practice Address - Street 1:115 W ARROWOOD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-5003
Practice Address - Country:US
Practice Address - Phone:704-523-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist