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Individual

KENNETH MENZEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
421 SE OSCEOLA ST, STUART, FL 34994-2505
(772) 286-0338
(772) 287-1139
Mailing address
421 SE OSCEOLA ST, STUART, FL 34994-2505
(772) 286-0338
(772) 287-1139

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3028672
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3079201-00
FL
01
430066581
RR MEDICARE
FL
01
G1987
BCBS OF FLORIDA
FL
Enumeration date
08/12/2006
Last updated
04/23/2008
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