Provider Demographics
NPI:1114948726
Name:KEDAR, AMOS (MD)
Entity Type:Individual
Prefix:DR
First Name:AMOS
Middle Name:
Last Name:KEDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMOS
Other - Middle Name:
Other - Last Name:KEDAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-392-5633
Mailing Address - Fax:352-392-8725
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-392-5633
Practice Address - Fax:352-392-8725
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME533942080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04742000Medicaid
FL68447ZMedicare PIN
FL04742000Medicaid
FLD57906Medicare UPIN