Desantis, Kevin J

Desantis, Kevin J is an individual health care provider with primary practice located at 1912 Kings Hwy Unit 700 , Port Charlotte FL 33980-4305. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Desantis, Kevin J can be contacted via phone (941) 255-0032.

Contact Information

Primary practice address
1912 Kings Hwy Unit 700 Port Charlotte FL 33980-4305
Phone: (941) 255-0032
Fax: (941) 391-5213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME58093 Florida
Allopathic & Osteopathic Physicians / General Practice 208D00000X ME58093 Florida

Profile Details

NPI number 1255353595
LBN Legal business name Desantis, Kevin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Jun 3rd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255353595 NPPES
Florida MEDICAID 064805100

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