Basic Information
| Provider Information | |||||||||
| NPI: | 1003010679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAHLON | ||||||||
| FirstName: | SUMMERPAL | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KAHLON | ||||||||
| OtherFirstName: | SUMMER | ||||||||
| OtherMiddleName: | SINGH | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 30 WOODLAND AVE, STE A | ||||||||
| Address2: | |||||||||
| City: | COCOA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329312886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216132004 | ||||||||
| FaxNumber: | 3216132031 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 WOODLAND AVE, STE A | ||||||||
| Address2: | |||||||||
| City: | COCOA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329312886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216132004 | ||||||||
| FaxNumber: | 3216132031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 05/16/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME101801 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | ME101801 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.