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General NPI Number Information
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NPI Number | 1275614612
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Entity Type | Individual
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Provider Name | JOSEPH JAMES KAVANAGH M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 21 COCONUT LN
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City | OCEAN RIDGE
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State | FL
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Zip | 33435-5202
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Country | US
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Telephone | 305-331-9580
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Fax |
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Provider Business Mailing Address
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Address Line | 21 COCONUT LN
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City | OCEAN RIDGE
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State | FL
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Zip | 33435-5202
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Country | US
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Telephone | 305-331-9580
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 042-0011291
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 04-33259
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 414164
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License Number State | FL
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