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:
Health care specialties
Specialty | Code | License # | 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 5 months ago |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1255353595 | NPPES |
Florida | MEDICAID | 064805100 |
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