MEDICARE: JEFFREY W KANSKI 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
1	174400000X	Specialist	ME83915	FL
2	2085R0001X	Radiation Oncology Physician	ME83915	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1326044496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY W KANSKI M.D.

Provider Business Mailing Address
First Line	:	2845 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2910
Country	:	US
Telephone Number	:	561-693-0540
Fax Number	:	561-296-6174

Provider Business Practice Location Address
First Line	:	5101 OKEECHOBEE RD
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-5415
Country	:	US
Telephone Number	:	772-595-5995
Fax Number	:	772-595-5990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	01/05/2021

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