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General NPI Number Information
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NPI Number | 1285668897
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Entity Type | Individual
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Provider Name | DEVENDRA S KAHLON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 40124N US 27 SUITE 102
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City | DAVENPORT
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State | FL
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Zip | 33837
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Country | US
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Telephone | 863-419-1166
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Fax | 863-419-1188
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Provider Business Mailing Address
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Address Line | 321 E ROBERTSON ST
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City | BRANDON
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State | FL
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Zip | 33511-5253
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Country | US
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Telephone | 813-685-2191
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Fax | 813-689-8755
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME0069617
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License Number State | FL
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