Healthcare Provider Details

I. General information

NPI: 1417586975
Provider Name (Legal Business Name): KAMAL HITENDRA MAKATI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3346 US HIGHWAY 19
HOLIDAY FL
34691-1846
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 727-615-6702
  • Fax:
Mailing address:
  • Phone: 615-315-5257
  • Fax: 615-692-0547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME158020
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: