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Individual

DR. KIANOOSH KAVEH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

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
0232474
CIGNA
FL
01
2142967000
AMERIHEALTH
FL
01
2142967000
INDEPENDENCE BC PA
PA
05
265580200
FL
01
2985402
AETNA BLUE BELL
GA
01
30030181
KEYSTONE MERCY HEALTH
FL
01
471501
TUFTS
01
47881
BCBS
FL
01
651117748T
BCBS IL
IL
01
651256
COMBINED INS
FL
01
7039169
AETNA
FL
01
7405063
MAMSI INS
01
KKA150339
BCBS EXCELLUS NY
05
N279248
FL
Enumeration date
08/10/2005
Last updated
04/29/2010
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