Provider Demographics
NPI:1154600468
Name:CORNEILLE, KARLY (RRT)
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:CORNEILLE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WEYBRIDGE CIRCLE
Mailing Address - Street 2:APT C
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1517
Mailing Address - Country:US
Mailing Address - Phone:561-633-7418
Mailing Address - Fax:
Practice Address - Street 1:106 WEYBRIDGE CIR
Practice Address - Street 2:APT C
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1517
Practice Address - Country:US
Practice Address - Phone:561-633-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT69242279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care