Provider Demographics
NPI:1619411980
Name:MASSAY-BRANK, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MASSAY-BRANK
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 1:822 ASPENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-8828
Mailing Address - Country:US
Mailing Address - Phone:407-908-9018
Mailing Address - Fax:407-740-6471
Practice Address - Street 1:822 ASPENWOOD CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-8828
Practice Address - Country:US
Practice Address - Phone:407-908-9018
Practice Address - Fax:407-740-6471
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities