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Individual

KENNETH DUFFY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 W 49TH ST, STE 717, HIALEAH, FL 33012-2900
(239) 331-8690
Mailing address
4100 CORPORATE SQ, STE 153, NAPLES, FL 34104-4714
(239) 331-8690

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
232728
FL
376J00000X
Homemaker
Primary
232728
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005937900
FL
Enumeration date
05/21/2014
Last updated
05/21/2014
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