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NPI Code Detail

MEDICARE: MYRON L KWAN M.D.

MEDICARE: MYRON L KWAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME0062276FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164427381
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRON L KWAN M.D.
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 941-244-9430
Fax Number : 941-244-9437
Provider Business Practice Location Address
First Line : 8383 S TAMIAMI TRL UNIT 115
Second Line :
City : SARASOTA
State : FL
Zip : 34238-2901
Country : US
Telephone Number : 941-244-9430
Fax Number : 941-244-9437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 08/04/2022

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