Organization
ASIF KAMAL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE RUSSELL (ADMINISTRATOR)
(941) 889-7440
Entity
Organization
Contact information
Practice address
21202 OLEAN BLVD STE C6, PORT CHARLOTTE, FL 33952-6771
(941) 889-7440
(941) 391-6089
Mailing address
21202 OLEAN BLVD STE C6, PORT CHARLOTTE, FL 33952-6771
(941) 889-7440
(941) 391-6089
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME71572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME71572
STATE LICENSE
FL
Enumeration date
04/07/2014
Last updated
08/06/2024
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