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Organization
SANDFORD H KINNE III D O P A
Active
Organization
SANDFORD H KINNE III D O P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDFORD HALSEY KINNE III DO (OWNER/SELF)
(386) 677-5600
Entity
Organization
Contact information
Practice address
290 CLYDE MORRIS BLVD, SUITE A-1, ORMOND BEACH, FL 32174-8130
(386) 677-5600
(386) 677-5686
Mailing address
PO BOX 731869, ORMOND BEACH, FL 32173-1869
(386) 677-5600
(386) 677-5686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0006791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375409000
—
FL
Enumeration date
05/20/2009
Last updated
05/20/2009
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