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General NPI Number Information
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NPI Number | 1992364962
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Entity Type | Individual
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Provider Name | DANIEL CHAN KIM DO, MBA
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Gender | Male
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 2501 N ORANGE AVE STE 401
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City | ORLANDO
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State | FL
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Zip | 32804-4644
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Country | US
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Telephone | 407-303-1332
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Fax | 407-303-0473
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Provider Business Mailing Address
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Address Line | 2501 N ORANGE AVE STE 401
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City | ORLANDO
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State | FL
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Zip | 32804-4644
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Country | US
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Telephone | 407-303-1332
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Fax | 407-303-0347
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS20602
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License Number State | FL
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