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NPI Code Detail

MEDICARE: DR. PAMELA MARA KANE D.O.

MEDICARE:  DR. PAMELA MARA KANE  D.O.
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
1207Q00000XFamily Medicine PhysicianOS8586FL

General Provider Information

NPI Number : 1255605747
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAMELA MARA KANE D.O.
Provider Business Mailing Address
First Line : 6643 NW 24TH TER
Second Line :
City : BOCA RATON
State : FL
Zip : 33496-3637
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 SHERIDAN ST
Second Line : SUITE 401
City : HOLLYWOOD
State : FL
Zip : 33021-3409
Country : US
Telephone Number : 561-239-8149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2012
Last Update Date : 02/29/2012

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Directions to “ DR. PAMELA MARA KANE D.O.” Practice Location

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