Kwak, Michael

Kwak, Michael is an sole proprietor health care provider with primary practice located at 175 W Pine Ave , Longwood FL 32750-4168. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Kwak, Michael can be contacted via phone (321) 207-0172.

Contact Information

Primary practice address
175 W Pine Ave Longwood FL 32750-4168
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X ME144520 Florida
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X A138880 California

Profile Details

NPI number 1376961326
LBN Legal business name Kwak, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 6th, 2014
Last updated Jan 6th, 2024 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376961326 NPPES
Florida MEDICAID 106695900
Florida MEDICAID MK3232267556

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