Provider Demographics
NPI:1114959863
Name:KAHN, JOEL ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ANDREW
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 W CANTON AVE APT B338
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7502
Mailing Address - Country:US
Mailing Address - Phone:617-438-6063
Mailing Address - Fax:
Practice Address - Street 1:940 W CANTON AVE APT B338
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7502
Practice Address - Country:US
Practice Address - Phone:617-438-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA72912207R00000X
FLME140067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine