Individual
REILEY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 S ORANGE AVE FL 4, ORLANDO, FL 32806-1215
(321) 841-6444
(407) 445-3515
Mailing address
1222 S ORANGE AVE FL 4, ORLANDO, FL 32806-1215
(321) 841-6444
(407) 445-3515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA9119506
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124545800
—
FL
Enumeration date
07/22/2024
Last updated
11/04/2024
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