MEDICARE: DR. BINDU ANN KAKKANATT MD

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	208000000X	Pediatrics Physician	ME 92430	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346358355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BINDU ANN KAKKANATT MD

Provider Business Mailing Address
First Line	:	1551 BOREN DR STE A
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2966
Country	:	US
Telephone Number	:	407-395-2037
Fax Number	:	407-395-2038

Provider Business Practice Location Address
First Line	:	1551 BOREN DR STE A
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2966
Country	:	US
Telephone Number	:	407-395-2037
Fax Number	:	407-395-2083

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	01/25/2023

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