Provider Demographics
NPI:1407018328
Name:PATRICK M KANE MD PA
Entity Type:Organization
Organization Name:PATRICK M KANE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOLARYNGOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-263-8855
Mailing Address - Street 1:848 1ST AVE N
Mailing Address - Street 2:SUITE 330
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6013
Mailing Address - Country:US
Mailing Address - Phone:239-263-8855
Mailing Address - Fax:239-263-0680
Practice Address - Street 1:848 1ST AVE N
Practice Address - Street 2:SUITE 330
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6013
Practice Address - Country:US
Practice Address - Phone:239-263-8855
Practice Address - Fax:239-263-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041439207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067583100Medicaid
FLAN059Medicare PIN
FLD54904Medicare UPIN