NPIMap

Organization Active NPI

Lina Kanj MD PA

  • Dermatology Physician
  • West Melbourne, FL
National Provider Identifier
1396907853
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME85500 Issued in FL
Legal business name
LINA KANJ MD PA
Practice address
1936 Dairy Rd
West Melbourne, FL 32904-4046
Phone
(321) 724-1319
Fax
(321) 724-1776
NPI assigned
Jun 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Authorized official

Name
Dr. Lina Kanj, M.D.
Title
President
Phone
(321) 724-1319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME85500 FL Primary

Addresses

Primary practice location

1936 Dairy Rd
West Melbourne, FL 32904-4046

Mailing address

PO Box 412017
Melbourne, FL 32941-2017
Phone (321) 724-1319

National Provider Directory

National Provider Directory

Locations

1936 Dairy Rd
West Melbourne, FL 32904
Phone (321) 259-7500

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1396907853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412017",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329412017",
            "telephone_number": "321-724-1319",
            "fax_number": "321-724-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 DAIRY RD",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329044046",
            "telephone_number": "321-724-1319",
            "fax_number": "321-724-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINA KANJ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "KANJ",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-724-1319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME85500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.