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Individual

DR. KEVIN C OLOUGHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13800 VETERANS WAY, ORLANDO, FL 32827-7401
(407) 631-1000
Mailing address
13668 CHAUVIN AVE, ORLANDO, FL 32827-3820
(775) 225-4378

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD41923
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100509540
NV
01
11564457
CAQH
Enumeration date
07/20/2005
Last updated
05/14/2020
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