Shamlou, K Kevin
Shamlou, K Kevin is an individual health care provider with primary practice located at 1673 Mason Ave Suite# 305, Daytona Beach FL 32117-5515. He recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Shamlou, K Kevin can be contacted via phone (386) 274-7118.Contact Information
Primary practice address
1673 Mason Ave Suite# 305
Daytona Beach FL 32117-5515
Phone: (386) 274-7118
Fax: (386) 274-6173
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Therapeutic Radiology | 2085R0203X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME0063960 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | ME0063960 | Florida |
Profile Details
| NPI number | 1699717124 |
|---|---|
| LBN Legal business name | Shamlou, K Kevin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Jul 1st, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699717124 | NPPES |
| Florida | Other | 68718 | BLUE CROSS BLUE SHIELD |
| Florida | MEDICAID | 375394800 | BLUE CROSS BLUE SHIELD |
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