Basic Information
Provider Information
NPI: 1568104255
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAINTER
FirstName: KAPIL
MiddleName: HEMANT
NamePrefix:  
NameSuffix:  
Credential: MBBS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8602 EDGE O WOODS CT
Address2:  
City: ORLANDO
State: FL
PostalCode: 328194138
CountryCode: US
TelephoneNumber: 4074465514
FaxNumber:  
Practice Location
Address1: 1102 BARCLAY ST
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782077161
CountryCode: US
TelephoneNumber: 2102337000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/12/2022
LastUpdateDate: 04/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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