Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | ME100772 | FL |
N | 208200000X | Surgeon | 2011-01105 | NC |
N | 208600000X | Surgeon | 2011-01105 | NC |
N | 208200000X | Surgeon | 8180 | SD |
N | 208600000X | Surgeon | 8180 | SD |
N | 208200000X | Surgeon | ME100772 | FL |
N | 208600000X | Surgeon | ME100772 | FL |
NPI | 1619166535 |
---|---|
Provider Name | Dr. William Fitzgerald Kendall JR. |
First Address | St Petersburg, FL 33709-2149 |
Second Address | Largo, FL 33770-3120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 14/01/2021 |