Individual
KEVIN P KINGSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2501 N ORANGE AVE STE 411, ORLANDO, FL 32804-4644
(407) 303-1373
(407) 303-0852
Mailing address
2501 N ORANGE AVE STE 411, ORLANDO, FL 32804-4644
(407) 303-1373
(407) 303-0852
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA3008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290275300
—
FL
Enumeration date
05/16/2006
Last updated
11/19/2018
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