Individual
DR. KIRKSAK JAY POONKASEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 461-8231
Mailing address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 461-8231
(727) 298-6637
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
ME98316
FL
207Q00000X
Family Medicine Physician
ME98316
FL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
ME98316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015913400
—
FL
Enumeration date
07/03/2008
Last updated
10/18/2022
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