# KANAN MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AltamonteMD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003369661
- **Authorized official:** RHONDA KANAN (COO)
- **Authorized official phone:** (407) 767-0009

## Contact information

- **Practice address:** 460 E ALTAMONTE DR, SUITE 2200, ALTAMONTE SPRINGS, FL 32701-4612
- **Practice address phone:** (407) 767-0009
- **Practice address fax:** (407) 767-0022
- **Mailing address:** 460 E ALTAMONTE DR, SUITE 2200, ALTAMONTE SPRINGS, FL 32701-4612
- **Mailing address phone:** (407) 767-0009
- **Mailing address fax:** (407) 767-0022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2016
- **Last updated:** 07/25/2022