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General NPI Number Information
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NPI Number | 1174985048
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Entity Type | Individual
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Provider Name | ABHISHEK SURESH KANNAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 7243 DELLA DR STE 1
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City | ORLANDO
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State | FL
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Zip | 32819-5104
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Country | US
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Telephone | 321-843-5851
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Fax | 321-842-0089
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Provider Business Mailing Address
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Address Line | 7243 DELLA DR STE 1
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City | ORLANDO
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State | FL
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Zip | 32819-5104
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Country | US
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Telephone | 321-843-5851
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Fax | 321-842-0089
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME156698
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME156698
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | K550017894570
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License Number State | FL
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