Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME69760 | FL |
N | 2081P2900X | Pain Medicine | ME0069760 | FL |
N | 2081S0010X | Sports Medicine | ME0069760 | FL |
N | 213ES0000X | Sports Medicine | ME0069760 | FL |
NPI | 1407881576 |
---|---|
Provider Name | Colin Lee Kanar |
First Address | Naples, FL 34108-0136 |
Second Address | Naples, FL 34110-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 28/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
379550100 | (05) | FL |
F85055 | (02) | FL |