Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 249785 | NY |
Y | 2080P0214X | Pediatric Pulmonologist | ME110394 | FL |
NPI | 1417188723 |
---|---|
Provider Name | Dr. Kevin Nirappukandathil Kuriakose |
First Address | Windermere, FL 34786-5593 |
Second Address | Winter Park, FL 32789-3385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 29/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1417188723 | (05) | FL |