Organization
KIANOOSH KAVEH DO PA
Active
Other names
COASTAL NEPHROLOGY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
KIANOOSH KAVEH DO PA (OWNER)
(941) 505-8720
Entity
Organization
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
—
0323474
CIGNA
FL
01
—
2142967000
AMERIHEALTH
FL
01
—
2148967000
INDEPENDENCE BC PA
PA
01
—
24133
BCBS FL GRP NUMBER
FL
05
—
265580200
—
FL
01
—
2985402
AETNA BLUE BELL
FL
01
—
30030181
KEYSTONE MERCY HEALTH
FL
01
—
471501
TUFTS
—
01
—
651256
COMBINED INS
FL
01
—
7405063
MAMSI INS
—
01
—
9814293
AETNA
FL
01
—
KKA150339
BCBS EXCELLUS NY
—
05
—
N279248
—
FL
Enumeration date
08/09/2005
Last updated
04/07/2014
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