Provider Demographics
NPI:1740556471
Name:KAKNES, NICHOLAS GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:GEORGE
Last Name:KAKNES
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 1:1800 N BAYSHORE DR APT 707
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3223
Mailing Address - Country:US
Mailing Address - Phone:786-351-3888
Mailing Address - Fax:
Practice Address - Street 1:1800 N BAYSHORE DR APT 707
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-3223
Practice Address - Country:US
Practice Address - Phone:786-351-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124823208M00000X, 2083B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist