Provider Demographics
NPI:1144881889
Name:KOEBEL, IVANA KARABAN
Entity type:Individual
Prefix:MRS
First Name:IVANA
Middle Name:KARABAN
Last Name:KOEBEL
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 1:4416 W MCELROY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3314
Mailing Address - Country:US
Mailing Address - Phone:813-244-5480
Mailing Address - Fax:
Practice Address - Street 1:4416 W MCELROY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-3314
Practice Address - Country:US
Practice Address - Phone:813-244-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program