Organization
KENNETH W FIELDS DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH FIELDS MD (MD)
(239) 262-7546
Entity
Organization
Contact information
Practice address
5100 TAMIAMI TRAIL N, 102, NAPLES, FL 34103-2810
(239) 262-7546
(239) 262-2403
Mailing address
5100 TAMIAMI TRAIL N, 102, NAPLES, FL 34103-2810
(239) 262-7546
(239) 262-2403
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME0045217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08326
BLUE CROSS BLUE SHIELD FLORIDA
FL
Enumeration date
03/06/2012
Last updated
03/06/2012
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