Provider Demographics
NPI:1194299412
Name:GUNNING HARRY, KARIBA
Entity type:Individual
Prefix:
First Name:KARIBA
Middle Name:
Last Name:GUNNING HARRY
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 1:3897 15TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-4049
Mailing Address - Country:US
Mailing Address - Phone:727-488-0601
Mailing Address - Fax:
Practice Address - Street 1:3897 15TH AVE SE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-4049
Practice Address - Country:US
Practice Address - Phone:727-488-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL19000015772253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care