Individual
KENDAL LAFAYETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5501 PERRINE DR, ORLANDO, FL 32808-2410
(407) 914-8931
Mailing address
4517 S LAKE ORLANDO PKWY, ORLANDO, FL 32808-2220
(321) 947-6107
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46-4823038
HUMANA
FL
Enumeration date
12/19/2022
Last updated
12/19/2022
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