Provider Demographics
NPI:1396741674
Name:KANE, PATRICK MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:KANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:239-263-8855
Mailing Address - Fax:239-263-0680
Practice Address - Street 1:860 111TH AVE N STE 3
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1833
Practice Address - Country:US
Practice Address - Phone:239-263-8855
Practice Address - Fax:239-263-0680
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2023-06-01
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
FLME0041439207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067583100Medicaid
FL44181Medicare ID - Type Unspecified
FL067583100Medicaid