Individual
DR. KAMAL K. POURMOGHADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1222 S ORANGE AVE, MP 817, ORLANDO, FL 32806-1215
(407) 649-6907
(407) 481-2035
Mailing address
1222 S ORANGE AVE, MP 817, ORLANDO, FL 32806-1215
(407) 649-6907
(407) 481-2035
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD067818L
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD067818L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001759842
—
PA
Enumeration date
04/19/2006
Last updated
04/24/2014
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