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Individual

DR. KENNETH RICHARD HODOR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20295 NE 29TH PL, SUITE# 300, AVENTURA, FL 33180-4109
(305) 932-7366
(305) 932-1271
Mailing address
20295 NE 29TH PL, SUITE# 300, AVENTURA, FL 33180-4109
(305) 932-7366
(305) 932-1271

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0017075
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0525847007
CIGNA
FL
01
200075
AVMED
FL
01
4592937
AETNA
FL
01
91939
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/03/2006
Last updated
07/08/2007
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