Provider Demographics
NPI:1346358355
Name:KAKKANATT, BINDU ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:BINDU
Middle Name:ANN
Last Name:KAKKANATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BINDU
Other - Middle Name:ANN
Other - Last Name:PAREKATTIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1551 BOREN DR STE A
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2966
Mailing Address - Country:US
Mailing Address - Phone:407-395-2037
Mailing Address - Fax:407-395-2038
Practice Address - Street 1:1551 BOREN DR STE A
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2966
Practice Address - Country:US
Practice Address - Phone:407-395-2037
Practice Address - Fax:407-395-2083
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 92430208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273859700Medicaid
FLU6201XMedicare PIN
I44188Medicare UPIN
FL273859700Medicaid