Provider Demographics
NPI:1043698111
Name:GOYAL, KAMAL KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:KUMAR
Last Name:GOYAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMAL
Other - Middle Name:K
Other - Last Name:GOYAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:7727 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8224
Practice Address - Country:US
Practice Address - Phone:407-303-6413
Practice Address - Fax:407-303-6414
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA325523207P00000X
FLME132449207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine