MEDICARE: DR. OMAR R KAYALEH 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	207RH0003X	Hematology & Oncology Physician	ME53036	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	:	1407830193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR R KAYALEH MD

Provider Business Mailing Address
First Line	:	1400 S ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6100
Country	:	US
Telephone Number	:	407-648-3800
Fax Number	:	407-425-5203

Provider Business Practice Location Address
First Line	:	1400 S ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6100
Country	:	US
Telephone Number	:	407-648-3800
Fax Number	:	407-425-5203

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	11/09/2016

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