Individual
KENNETH WAYNE KOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1133 SEMINOLE DR, ROCKLEDGE, FL 32955-2836
(321) 637-2975
(321) 433-1935
Mailing address
PO BOX 11406, BELFAST, ME 04915-4005
(321) 637-2975
(321) 433-1935
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME28087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057749900
—
FL
01
—
15359
BLUE SHIELD
FL
01
—
407113416
RAILROAD MEDICARE
FL
Enumeration date
03/08/2006
Last updated
04/15/2015
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