Basic Information
| Provider Information | |||||||||
| NPI: | 1194151589 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DE SOUZA FERREIRA HUNT | ||||||||
| FirstName: | KAREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1357 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339021357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392783600 | ||||||||
| FaxNumber: | 2392264650 | ||||||||
| Practice Location | |||||||||
| Address1: | 316 DEL PRADO BLVD S | ||||||||
| Address2: | |||||||||
| City: | CAPE CORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339901710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393141616 | ||||||||
| FaxNumber: | 2397721613 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2013 | ||||||||
| LastUpdateDate: | 05/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME126501 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 016678800 | 05 | FL | MEDICAID |