MEDICARE: YEHONATAN KANE MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number	:	1205451614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YEHONATAN KANE MD LLC

Provider Business Mailing Address
First Line	:	275 N FEDERAL HWY APT 414
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-4347
Country	:	US
Telephone Number	:	786-564-9565
Fax Number	:

Provider Business Practice Location Address
First Line	:	3561 SW 10TH ST
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4827
Country	:	US
Telephone Number	:	786-564-9565
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	YEHONATAN KANE
Credential	:	MD
Telephone Number	:	786-564-9565

Provider Enumeration Date	:	06/11/2020
Last Update Date	:	07/20/2020

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