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General NPI Number Information
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NPI Number | 1104970417
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Entity Type | Individual
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Provider Name | PATRICK DESMOND KAVANAGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1430 S DIXIE HWY STE 304
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City | CORAL GABLES
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State | FL
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Zip | 33146-3159
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Country | US
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Telephone | 888-696-4322
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 BO BAJURAS VILLA MONTANA UNIT B3
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 305-354-0458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101264898
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA09668800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME96603
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License Number State | FL
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