Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | ME104557 | FL |
NPI | 1164450508 |
---|---|
Provider Name | James Erasmus Kendrick IV |
First Address | Orlando, FL 32804-4648 |
Second Address | Orlando, FL 32804-4648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 30/04/2014 |