Organization
KP MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENIEL PENA (PRESIDENT)
(786) 308-6024
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD STE 1R, MIAMI, FL 33172-4511
(786) 542-5173
(786) 536-2512
Mailing address
175 FONTAINEBLEAU BLVD STE 1R, MIAMI, FL 33172-4511
(786) 542-5173
(786) 536-2512
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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