Individual
TCHAVIAN S KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 N OBSERVATORY DR, ORLANDO, FL 32835-1215
(321) 362-2576
Mailing address
325 N OBSERVATORY DR, ORLANDO, FL 32835-1215
(321) 362-2576
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744424
—
FL
Enumeration date
03/21/2019
Last updated
03/21/2019
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