Kanan Medical, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

KANAN MEDICAL, LLC

Practice address

460 E Altamonte Dr
Suite 2200
Altamonte Springs, FL 32701-4612

Phone

(407) 767-0009

Fax

(407) 767-0022

NPI assigned

Aug 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rhonda Kanan

Title

Coo

Phone

(407) 767-0009

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• AltamonteMD Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14527/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pedro Luis Gonzalez-Morales, MD

  • Internal Medicine Physician
  • Altamonte Springs, FL
  • NPI 1861682270
  Medicare reassignment Care Compare group NPD
• Lindsey Watson, APRN

  • Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1851854103
  Medicare reassignment Care Compare group NPD
• Courtney Zakshevsky, PA

  • Physician Assistant
  • Tampa, FL
  • NPI 1255827630
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1003369661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 E ALTAMONTE DR",
            "address_2": "SUITE 2200",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014612",
            "telephone_number": "407-767-0009",
            "fax_number": "407-767-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 E ALTAMONTE DR",
            "address_2": "SUITE 2200",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014612",
            "telephone_number": "407-767-0009",
            "fax_number": "407-767-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 N Causeway",
            "address_purpose": "LOCATION",
            "city": "New Smyrna Beach",
            "state": "FL",
            "postal_code": "321695239",
            "country_code": "US",
            "telephone_number": "386-387-2202",
            "fax_number": "407-767-0022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "413 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "327711207",
            "country_code": "US",
            "telephone_number": "407-767-0009",
            "fax_number": "407-767-0022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2705 Rebecca Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Orange City",
            "state": "FL",
            "postal_code": "327638336",
            "country_code": "US",
            "telephone_number": "407-767-0009",
            "fax_number": "407-767-0022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Marshall Farms Rd",
            "address_purpose": "LOCATION",
            "city": "Ocoee",
            "state": "FL",
            "postal_code": "347613316",
            "country_code": "US",
            "telephone_number": "407-767-0009",
            "fax_number": "407-767-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KANAN MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "KANAN",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "407-767-0009"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023512400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltamonteMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mernise Lubin Juste, BS
• K&a Prperty Solutions, LLC
• Marci Kagan
• Nicole Kalagassy
• Jenny Kalich
• Martin Stanley Kane, M.D.
• Casie Kansol, BA
• Ajay Mahesh Kapadia, D.M.D.
• Albert Anthony Kaplan, D.P.M
• Rossana Michelle Karagiannis, CNM

• Multi-Specialty Clinic/Center in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.