Poonkasem, Kirksak Jay

Poonkasem, Kirksak Jay is an individual health care provider with primary practice located at 300 Pinellas St , Clearwater FL 33756-3804. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is his primary health care specialty. Poonkasem, Kirksak Jay can be contacted via phone (727) 461-8231.

Contact Information

Primary practice address
300 Pinellas St Clearwater FL 33756-3804
Phone: (727) 461-8231
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine 207QH0002X ME98316 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME98316 Florida

Profile Details

NPI number 1134382831
LBN Legal business name Poonkasem, Kirksak Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2008
Last updated Oct 18th, 2022 - about 2 years 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 1134382831 NPPES
Florida MEDICAID 015913400

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