Provider Demographics
NPI:1427245380
Name:KANG, SEUNG SHIN (DO)
Entity type:Individual
Prefix:MS
First Name:SEUNG
Middle Name:SHIN
Last Name:KANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 NW 12TH AVE BLDG 600B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1096
Mailing Address - Country:US
Mailing Address - Phone:305-585-6856
Mailing Address - Fax:305-355-2244
Practice Address - Street 1:1611 NW 12TH AVE BLDG 600B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1096
Practice Address - Country:US
Practice Address - Phone:305-585-6856
Practice Address - Fax:305-355-2244
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10180207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine