Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 2007-01088 | NC |
N | 213ES0000X | Sports Medicine | 2007-01088 | NC |
Y | 2081S0010X | Sports Medicine | ME139531 | FL |
Y | 213ES0000X | Sports Medicine | ME139531 | FL |
NPI | 1447338587 |
---|---|
Provider Name | Dr. Kenneth P Barnes |
First Address | Coral Gables, FL 33146 |
Second Address | Coral Gables, FL 33146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 29/05/2019 |