Provider Demographics
NPI:1811923311
Name:KAREN BALDWIN MD PA
Entity type:Organization
Organization Name:KAREN BALDWIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-657-6546
Mailing Address - Street 1:320 OAKFIELD DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5723
Mailing Address - Country:US
Mailing Address - Phone:813-657-6546
Mailing Address - Fax:813-657-6516
Practice Address - Street 1:320 OAKFIELD DR
Practice Address - Street 2:SUITE E
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5723
Practice Address - Country:US
Practice Address - Phone:813-657-6546
Practice Address - Fax:813-657-6516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373855800Medicaid