Provider Demographics
NPI:1174610968
Name:VANROOYEN, KARIN (PT)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:VANROOYEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1320
Mailing Address - Country:US
Mailing Address - Phone:863-314-9991
Mailing Address - Fax:863-314-0057
Practice Address - Street 1:3201 MEDICAL WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5412
Practice Address - Country:US
Practice Address - Phone:863-314-9991
Practice Address - Fax:863-314-0057
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY904TOtherBCBSFL GRP #
FLY904TOtherBCBSFL GRP #