Individual
ELIJAH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7727 LAKE UNDERHILL RD, DEPARTMENT OF EMERGENCY MEDICINE, ORLANDO, FL 32822-8224
(407) 303-6413
Mailing address
5870 HIATUS RD, TAMARAC, FL 33321-6424
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME136445
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2016
Last updated
05/12/2019
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