Organization
MARY ANN KENNESON, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYANN KENNESON MD (PRESIDENT)
(859) 421-3759
Entity
Organization
Contact information
Practice address
1895 KINGSLEY AVE STE 903, ORANGE PARK, FL 32073-4410
(904) 644-8353
(904) 644-8289
Mailing address
1895 KINGSLEY AVE STE 903, ORANGE PARK, FL 32073-4410
(904) 644-8353
(904) 644-8289
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME92864
FL
Other
Enumeration date
09/07/2012
Last updated
03/02/2018
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