Individual
DR. KENNETH J. BREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1921 WALDEMERE ST STE 310, SARASOTA, FL 34239
(941) 917-5400
(941) 917-5420
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME62142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1192944
WELLCARE
FL
01
—
17793
BCBS
FL
01
—
202233
AMERIGROUP PROVIDER #
FL
01
—
2780250
BCBS FL PROVIDER #
FL
01
—
340017280
MEDICARE RR
FL
05
—
373532000
—
FL
01
—
4345646
AETNA PROVIDER #
FL
01
—
P00449108
RAILROAD MEDICARE
FL
Enumeration date
08/22/2005
Last updated
06/19/2018
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