Basic Information
Provider Information
NPI: 1609217231
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESLER
FirstName: KARLIE
MiddleName: PLEASANT
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 13833
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191013833
CountryCode: US
TelephoneNumber: 3522736818
FaxNumber:  
Practice Location
Address1: 1600 SW ARCHER RD
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326103003
CountryCode: US
TelephoneNumber: 3522657999
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/11/2013
LastUpdateDate: 10/15/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA9107282FLY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

ID Information
IDTypeStateIssuerDescription
00919020005FL MEDICAID


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