Individual
KENNETH J. MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5415 SW 64TH ST, GAINESVILLE, FL 32608-9605
(352) 338-4900
Mailing address
PO BOX 540305, MERRITT ISLAND, FL 32954-0305
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
ME 49922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000785500
—
FL
Enumeration date
02/07/2007
Last updated
04/12/2011
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