Provider Demographics
NPI:1770090623
Name:REDOUAN, KARIMA R (FNP)
Entity type:Individual
Prefix:MRS
First Name:KARIMA
Middle Name:R
Last Name:REDOUAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5811 LEOPARDSTOWN DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-8060
Mailing Address - Country:US
Mailing Address - Phone:813-405-5885
Mailing Address - Fax:
Practice Address - Street 1:5811 LEOPARDSTOWN DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-8060
Practice Address - Country:US
Practice Address - Phone:813-405-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF12170094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F12170094OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD