Individual
DR. KENNETH ETHAN LAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7208 W SAND LAKE RD STE 305, ORLANDO, FL 32819-5279
(407) 799-8808
(407) 440-4307
Mailing address
6968 PHILLIPS RESERVE CT FL 7208W, ORLANDO, FL 32819-7809
(407) 558-0188
(407) 440-4307
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
114891
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184190753
MEDICARE PART B
FL
Enumeration date
09/12/2012
Last updated
06/11/2021
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