Healthcare Provider Details

I. General information

NPI: 1982706362
Provider Name (Legal Business Name): MICHAEL PAUL KAHKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ORANGE AVE
ORLANDO FL
32806-2134
US

IV. Provider business mailing address

1400 S ORANGE AVE
ORLANDO FL
32806-2134
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-5001
  • Fax: 321-843-5085
Mailing address:
  • Phone: 321-843-5001
  • Fax: 321-843-5085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME0064894
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME0064894
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: