Individual
COLIN FRANK KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
220 BARTON BLVD UNIT C-14, ROCKLEDGE, FL 32955-2742
(321) 241-6800
(321) 241-6890
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9114032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111121400
—
FL
Enumeration date
04/12/2021
Last updated
08/03/2023
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