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NPI Code Detail

MEDICARE: COLIN LEE KANAR M.D.

MEDICARE: COLIN LEE KANAR 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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianME0069760FL
22081S0010XSports Medicine (Physical Medicine & Rehabilitation) PhysicianME0069760FL
3208100000XPhysical Medicine & Rehabilitation PhysicianME69760FL
42081N0008XNeuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianME69760FL

Other Identifiers

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

General Provider Information

NPI Number : 1407881576
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLIN LEE KANAR M.D.
Provider Business Mailing Address
First Line : PO BOX 112108
Second Line :
City : NAPLES
State : FL
Zip : 34108-0136
Country : US
Telephone Number : 239-593-0918
Fax Number : 239-593-0927
Provider Business Practice Location Address
First Line : 11983 TAMIAMI TRL N
Second Line : SUITE 100D
City : NAPLES
State : FL
Zip : 34110-1603
Country : US
Telephone Number : 239-593-0918
Fax Number : 239-593-0927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 10/28/2015

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