Provider Demographics
NPI:1477864874
Name:ALICIA S. KANHAI, D.P.M., P.A.
Entity Type:Organization
Organization Name:ALICIA S. KANHAI, D.P.M., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:SHELLY
Authorized Official - Last Name:KANHAI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:813-382-4920
Mailing Address - Street 1:8113 BRINEGAR CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1769
Mailing Address - Country:US
Mailing Address - Phone:813-383-4920
Mailing Address - Fax:
Practice Address - Street 1:3355 W BEARSS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2100
Practice Address - Country:US
Practice Address - Phone:813-443-4549
Practice Address - Fax:813-482-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3057213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDX220AMedicare PIN