Individual
MR. KENT RILLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
4443 LYONS RD STE 211, COCONUT CREEK, FL 33073-4388
(954) 405-0501
(954) 301-8501
Mailing address
7611 MARBLEHEAD LN, PARKLAND, FL 33067-2336
(301) 922-9166
(954) 405-0501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0002135
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9109431
FL LICENSE
FL
Enumeration date
11/22/2006
Last updated
03/07/2023
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