Basic Information
Provider Information
NPI: 1528378155
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASKARI
FirstName: KAREN
MiddleName: RACEDO
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2900 CORPORATE WAY
Address2: DOOR D
City: MIRAMAR
State: FL
PostalCode: 330253925
CountryCode: US
TelephoneNumber: 9542765685
FaxNumber: 9549857074
Practice Location
Address1: 1150 N 35TH AVE STE 205A
Address2:  
City: HOLLYWOOD
State: FL
PostalCode: 330215424
CountryCode: US
TelephoneNumber: 9542657500
FaxNumber: 9542657555
Other Information
ProviderEnumerationDate: 10/16/2010
LastUpdateDate: 03/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RE0101X122749FLY Allopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism

No ID Information.


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