Healthcare Provider Details

I. General information

NPI: 1679831481
Provider Name (Legal Business Name): KAMALJIT KAUR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 MURRELL RD STE B
MELBOURNE FL
32940-7999
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-361-5589
  • Fax: 321-253-3805
Mailing address:
  • Phone: 321-361-5589
  • Fax: 321-253-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME123064
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: