Individual
KEVIN LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1578 W ORANGE BLOSSOM TRL, APOPKA, FL 32712-2639
(407) 635-3240
(407) 636-7847
Mailing address
1578 W ORANGE BLOSSOM TRL, APOPKA, FL 32712-2639
(407) 635-3240
(407) 636-7847
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME161624
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118675400
—
FL
Enumeration date
03/22/2019
Last updated
08/25/2023
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