Provider Demographics
NPI:1861846263
Name:KAHANE, IAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:M
Last Name:KAHANE
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 1:3303 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-2550
Mailing Address - Country:US
Mailing Address - Phone:941-748-8069
Mailing Address - Fax:
Practice Address - Street 1:3303 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-2550
Practice Address - Country:US
Practice Address - Phone:941-748-8069
Practice Address - Fax:941-748-6609
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139133207R00000X
FL39020000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program