Organization
KERSENBROCK MEDICAL AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN DALE KERSENBROCK (OWNER)
(407) 732-6920
Entity
Organization
Contact information
Practice address
760 CURRENCY CIR STE A, LAKE MARY, FL 32746-2138
(407) 732-6920
(407) 732-6923
Mailing address
760 CURRENCY CIR STE A, LAKE MARY, FL 32746-2138
(407) 732-6920
(407) 732-6923
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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