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Organization
KIANOOSH KAVEH DO PA
Active
Organization
KIANOOSH KAVEH DO PA
Active
Other names
COASTAL NEPHROLOGY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
KIANOOSH KAVEH DO PA (OWNER)
(941) 505-8720
Entity
Organization
Contact information
Practice address
3221 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8002
(941) 505-8720
(941) 505-8747
Mailing address
3221 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8002
(941) 505-8720
(941) 505-8747
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
OS8229
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000ZCY746
BCBS MASS
MA
01
—
001457915
BCBS HIGHMARK
—
01
—
0323474
CIGNA
FL
01
—
2142967000
AMERIHEALTH
FL
01
—
2148967000
INDEPENDENCE BC PA
PA
01
—
24133
BCBS FL GRP NUMBER
FL
05
—
265580200
—
FL
01
—
2985402
AETNA BLUE BELL
FL
01
—
30030181
KEYSTONE MERCY HEALTH
FL
01
—
471501
TUFTS
—
01
—
651256
COMBINED INS
FL
01
—
7405063
MAMSI INS
—
01
—
9814293
AETNA
FL
01
—
KKA150339
BCBS EXCELLUS NY
—
05
—
N279248
—
FL
Enumeration date
08/09/2005
Last updated
04/07/2014
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