Individual
DR. KENDALL K PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 N ORANGE AVE STE 815, ORLANDO, FL 32801-5203
(407) 898-1436
(407) 898-6330
Mailing address
2501 N ORANGE AVE, SUITE 442, ORLANDO, FL 32804-4603
(407) 898-1436
(407) 898-6330
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
056206
GA
208200000X
Plastic Surgery Physician
Primary
ME100894
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32038
BCBS
FL
05
—
789853741
—
GA
Enumeration date
06/06/2006
Last updated
12/04/2019
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