Individual
DR. KENNETH J FUQUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 JUPITER LAKES BLVD, BLDG 3000 SUITE 103, JUPITER, FL 33458-7191
(561) 745-6950
(561) 748-1806
Mailing address
210 JUPITER LAKES BLVD, BLDG 3000 SUITE 103, JUPITER, FL 33458-7191
(561) 745-6950
(561) 748-1806
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0062203
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250896600
—
FL
Enumeration date
04/28/2006
Last updated
09/24/2007
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