Provider Demographics
NPI:1902090871
Name:KAHL, TANYA R (DC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:R
Last Name:KAHL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 SW 8TH ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4055
Mailing Address - Country:US
Mailing Address - Phone:786-327-8179
Mailing Address - Fax:
Practice Address - Street 1:8500 SW 8TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4055
Practice Address - Country:US
Practice Address - Phone:786-327-8179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU95254Medicare UPIN
FL53879ZMedicare PIN