Individual
DR. STEPHEN JOSEPH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 7TH AVE N, ST PETERSBURG, FL 33705-1300
(727) 825-1100
(770) 237-4926
Mailing address
PO BOX 919379, ORLANDO, FL 32891-9379
(844) 453-1406
(772) 621-3180
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME61941
FL
2085R0202X
Diagnostic Radiology Physician
21797
ND
2085R0202X
Diagnostic Radiology Physician
Primary
ME61941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26874
FL BCBS
FL
01
—
26874U
FL MEDICARE
FL
05
—
376073100
—
FL
01
—
P01478716
FL MEDICARE RAILROAD PTAN
FL
Enumeration date
02/22/2006
Last updated
06/27/2025
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