Provider Demographics
NPI:1891157640
Name:MICHAEL KAWOHL, LLC
Entity Type:Organization
Organization Name:MICHAEL KAWOHL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:KAWOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-288-4681
Mailing Address - Street 1:1013 REVILLA LN
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2236
Mailing Address - Country:US
Mailing Address - Phone:321-288-4681
Mailing Address - Fax:
Practice Address - Street 1:1013 REVILLA LN
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2236
Practice Address - Country:US
Practice Address - Phone:321-288-4681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL05000117816332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment