Individual
DONALD E KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2450 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-3922
(941) 624-2704
(941) 627-6066
Mailing address
2460 OLD MOULTRIE RD, STE 2, ST AUGUSTINE, FL 32086-4198
(877) 856-3774
(239) 599-2625
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0004552
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82515
FL BC
FL
Enumeration date
11/23/2005
Last updated
12/04/2017
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