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Individual
JEFFREY KANNEN
Active
Individual
JEFFREY KANNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
OS16865
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2017
Last updated
03/26/2025
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