Healthcare Provider Details

I. General information

NPI: 1861829392
Provider Name (Legal Business Name): KALVIN KUNAL KAPOOR D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 W FLAGLER ST STE 900
MIAMI FL
33130-1807
US

IV. Provider business mailing address

6928 SW 39TH ST APT A208
DAVIE FL
33314-2471
US

V. Phone/Fax

Practice location:
  • Phone: 610-306-2618
  • Fax:
Mailing address:
  • Phone: 610-306-2618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberOS13693
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS13693
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: