Provider Demographics
NPI:1538367016
Name:KAHN, PAUL R (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:180 SW 84TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2731
Practice Address - Country:US
Practice Address - Phone:954-474-2929
Practice Address - Fax:954-474-9708
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2017-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME37234208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94125OtherBCBS FL
FL4106168OtherAETNA
FLPRL00000270258OtherPREFERRED MEDICAL PLAN
FL25735OtherMEDICA
FLP1002890OtherFREEDOM HEALTH
FLP943393OtherOPTIMUM
FL2698969OtherCIGNA
FL1315541OtherWELLCARE-MEDICARE ONLY
FL4701OtherDIMENSIONS HEALTH
FL212452OtherAVMED
FLF00028467703OtherUNITED HEALTHCARE
FLQMP000005196252OtherMOLINA
FL94125ZMedicare PIN
FLF00028467703OtherUNITED HEALTHCARE
FLQMP000005196252OtherMOLINA