Provider Demographics
NPI:1851787667
Name:KANDATHIPARAMPIL, ARLINE JOSE (MD)
Entity type:Individual
Prefix:
First Name:ARLINE
Middle Name:JOSE
Last Name:KANDATHIPARAMPIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:904-642-6100
Mailing Address - Fax:904-642-5154
Practice Address - Street 1:4972 TOWN CENTER PKWY UNIT 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8596
Practice Address - Country:US
Practice Address - Phone:904-642-6100
Practice Address - Fax:904-642-5154
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5722208000000X, 208000000X
FLME144665208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108753300Medicaid