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Individual
DR. MARK DAVID KENDRICK
Active
Individual
DR. MARK DAVID KENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0057676
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0575838
AETNA
FL
01
—
080164321
RAILROAD MEDICARE
FL
05
—
080164321
—
FL
01
—
59-3667262
TAX ID#
FL
01
—
MEDICARE GROUP
45360
FL
Enumeration date
09/25/2006
Last updated
10/29/2009
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