Provider Demographics
NPI:1588155949
Name:MANVAR, KAPILKUMAR CHHAGANLAL (MD)
Entity type:Individual
Prefix:
First Name:KAPILKUMAR
Middle Name:CHHAGANLAL
Last Name:MANVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KAPILKUMAR
Other - Middle Name:CHHAG
Other - Last Name:MANVAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:2572 W STATE ROAD 426 STE 3080
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8312
Practice Address - Country:US
Practice Address - Phone:407-565-2192
Practice Address - Fax:407-565-2285
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME168125207RH0000X, 207RX0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL122397300Medicaid