Basic Information
Provider Information | |||||||||
NPI: | 1528411410 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AU | ||||||||
FirstName: | KAROLYN | ||||||||
MiddleName: | HEI LUN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1095 NW 14TH TERRACE D4-6 | ||||||||
Address2: | DEPARTMENT OF NEUROLOGICAL SURGERY | ||||||||
City: | MIAMI | ||||||||
State: | FL | ||||||||
PostalCode: | 33136 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: |   | ||||||||
FaxNumber: | 3052433180 | ||||||||
Practice Location | |||||||||
Address1: | 1611 NW 12 AVENUE | ||||||||
Address2: | DEPARTMENT OF NEUROLOGICAL SURGERY | ||||||||
City: | MIAMI | ||||||||
State: | FL | ||||||||
PostalCode: | 33136 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3052436751 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/15/2016 | ||||||||
LastUpdateDate: | 04/19/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: | 02/27/2017 | ||||||||
NPIReactivationDate: | 04/19/2017 | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X |   |   | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 390200000X | TRN#23178 | FL | Y |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   |
No ID Information.