Provider Demographics
NPI:1861450827
Name:KAGAN JUGAN & ASSOCIATES PA
Entity Type:Organization
Organization Name:KAGAN JUGAN & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-936-6778
Mailing Address - Street 1:3210 CLEVELAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-7182
Mailing Address - Country:US
Mailing Address - Phone:239-936-6778
Mailing Address - Fax:239-936-1246
Practice Address - Street 1:3210 CLEVELAND AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7182
Practice Address - Country:US
Practice Address - Phone:239-936-6778
Practice Address - Fax:239-936-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40137OtherBCBS
FL40137OtherBCBS
FL40137Medicare PIN
FL0626040002Medicare NSC