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Individual

DR. KENNETH L. JANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4443 LYONS RD STE 211, COCONUT CREEK, FL 33073-4388
(954) 405-0501
(954) 301-8501
Mailing address
4443 LYONS RD STE 211, COCONUT CREEK, FL 33073-4388
(954) 405-0501
(954) 301-8501

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
ME111647
FL
208800000X
Urology Physician
036-043934
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-043934
IL
Enumeration date
04/13/2006
Last updated
06/18/2019
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