Individual
JEFFREY KIENZLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1921 WALDEMERE ST STE 705, SARASOTA, FL 34239-2913
(941) 366-5864
(941) 365-4276
Mailing address
1921 WALDEMERE ST, STE. 705, SARASOTA, FL 34239-2943
(941) 366-5864
(941) 365-4276
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA901427
FL
Other
Enumeration date
07/07/2006
Last updated
01/21/2022
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