Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME 93044 | FL |
Y | 111NI0900X | Internist | ME 93044 | FL |
N | 207RG0300X | Geriatric Medicine | ME 93044 | FL |
NPI | 1093991465 |
---|---|
Provider Name | Dr. Kenneth Alexander Kenyhercz |
First Address | Tampa, FL 33613-1248 |
Second Address | Tampa, FL 33613-1248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2008 |
Last Update Date | 16/01/2008 |