Provider Demographics
NPI:1558450023
Name:COLAK, KAYA (MD)
Entity Type:Individual
Prefix:
First Name:KAYA
Middle Name:
Last Name:COLAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E HILLSBORO BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4356
Mailing Address - Country:US
Mailing Address - Phone:954-426-3006
Mailing Address - Fax:954-481-9318
Practice Address - Street 1:2230 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6100
Practice Address - Country:US
Practice Address - Phone:954-753-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010619532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301061953OtherMICHIGAN LICENSE NUMBER
MI4301061953OtherMICHIGAN LICENSE NUMBER
H00462Medicare UPIN