Provider Demographics
NPI:1205890001
Name:KWAN, CHING KIT (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHING
Middle Name:KIT
Last Name:KWAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4949
Mailing Address - Country:US
Mailing Address - Phone:407-647-2287
Mailing Address - Fax:407-643-2807
Practice Address - Street 1:1285 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4949
Practice Address - Country:US
Practice Address - Phone:407-647-2287
Practice Address - Fax:407-643-2807
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103521363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6273ZMedicare ID - Type Unspecified
FLQ55051Medicare UPIN