MEDICARE: KIRTANE ASSOCIATES M.D., P.A.

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
1	207RG0100X	Gastroenterology Physician	ME37121	FL
2	207RP1001X	Pulmonary Disease Physician	ME38048	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME38048	OTHER	FL	LISCENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	ME37121	OTHER	FL	LISCENSE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174839476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIRTANE ASSOCIATES M.D., P.A.

Provider Business Mailing Address
First Line	:	PO BOX 160127
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32716-0127
Country	:	US
Telephone Number	:	407-788-7844
Fax Number	:	407-682-6071

Provider Business Practice Location Address
First Line	:	210 N WESTMONTE DR
Second Line	:	SUITE 1000
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-3311
Country	:	US
Telephone Number	:	407-788-7844
Fax Number	:	407-682-6071

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SHIRISH KAMALAKAR KIRTANE
Credential	:	M.D.
Telephone Number	:	407-788-7844

Provider Enumeration Date	:	08/24/2010
Last Update Date	:	08/24/2010

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Directions to “KIRTANE ASSOCIATES M.D., P.A. ” Practice Location

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