Organization
PAMELA S. KENNEDY, MD, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA KENNEDY M.D. (DERMATOLOGIST)
(850) 656-4555
Entity
Organization
Contact information
Practice address
1355 THOMASWOOD DRIVE, TALLAHASSEE, FL 32308
(850) 656-4555
Mailing address
1355 THOMASWOOD DRIVE, TALLAHASSEE, FL 32308
(850) 656-4555
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME 84319
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15007
MEDICARE ID
—
05
—
2807050-00
—
FL
Enumeration date
09/26/2011
Last updated
10/11/2011
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