1477864874 NPI number — ALICIA S. KANHAI, D.P.M., P.A.

Table of content: (NPI 1477864874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477864874 NPI number — ALICIA S. KANHAI, D.P.M., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALICIA S. KANHAI, D.P.M., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477864874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8113 BRINEGAR CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33647-1769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-383-4920
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3355 W BEARSS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33618-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-443-4549
Provider Business Practice Location Address Fax Number:
813-482-0718
Provider Enumeration Date:
06/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KANHAI
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
SHELLY
Authorized Official Title or Position:
PODIATRIST
Authorized Official Telephone Number:
813-382-4920

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  PO 3057 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com