Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME75879 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME75879 | FL |
NPI | 1467498691 |
---|---|
Provider Name | Kenneth S Jeffers |
First Address | Fort Lauderdale, FL 33309-3750 |
Second Address | Coral Springs, FL 33065-4139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 28/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
254901800 | (05) | FL |
262501 | BCBS (01) | FL |
I43818 | (02) |