Organization
KAREN E KENNEDY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN E KENNEDY M.D. (PRESIDENT)
(850) 916-7766
Entity
Organization
Contact information
Practice address
1118 GULF BREEZE PKWY, STE. 201, GULF BREEZE, FL 32561-7800
(850) 916-7766
(850) 916-5144
Mailing address
1118 GULF BREEZE PKWY, STE. 201, GULF BREEZE, FL 32561-7800
(850) 916-7766
(850) 916-5144
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
ME75325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701115
UNITED HEALTH CARE
FL
01
—
10D0270871
CMS CLIA
FL
01
—
21149353644
BEECH STREET
FL
05
—
261713700
—
FL
01
—
58754
BS FLORIDA
FL
01
—
59041231KEN
BS ALABAMA
FL
01
—
7856118
AETNA
FL
01
—
AD696
MEDICARE GRP EFF 10-2-06
FL
01
—
DG1413
RR MEDICARE GP#
FL
Enumeration date
06/25/2006
Last updated
02/22/2012
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