Provider Demographics
NPI:1235249657
Name:KAHN, SHAUN (DC)
Entity Type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-4634
Mailing Address - Country:US
Mailing Address - Phone:850-424-7856
Mailing Address - Fax:850-424-7858
Practice Address - Street 1:4481 LEGENDARY DR STE 150
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-5386
Practice Address - Country:US
Practice Address - Phone:850-424-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARU68431Medicare UPIN
AR5T742Medicare ID - Type Unspecified