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Individual

FADI KANDAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 WHETSTONE PL STE 102, SAINT AUGUSTINE, FL 32086-5775
(904) 342-8300
Mailing address
100 WHETSTONE PL STE 102, SAINT AUGUSTINE, FL 32086-5775
(904) 342-8300

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
UO6500
FL
207RC0000X
Cardiovascular Disease Physician
Primary
OS22197
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127955400
FL
Enumeration date
03/21/2019
Last updated
09/17/2025
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