Provider Demographics
NPI:1255304812
Name:KAMAL, ANUPAM (MD)
Entity Type:Individual
Prefix:
First Name:ANUPAM
Middle Name:
Last Name:KAMAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANUDAM
Other - Middle Name:
Other - Last Name:SHYAMKAMAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2730 N MCMULLEN BOOTH RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3302
Mailing Address - Country:US
Mailing Address - Phone:727-725-5224
Mailing Address - Fax:727-799-2183
Practice Address - Street 1:2730 N MCMULLEN BOOTH RD
Practice Address - Street 2:201
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3302
Practice Address - Country:US
Practice Address - Phone:727-725-5224
Practice Address - Fax:727-799-2183
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255700200Medicaid
FL255700200Medicaid
G41632Medicare UPIN