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NPI Code Detail

MEDICARE: KENDALL MCCARDELL

MEDICARE: KENDALL MCCARDELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA32334FL

General Provider Information

NPI Number : 1003531708
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL MCCARDELL
Provider Business Mailing Address
First Line : 1661 CENTRAL AVE UNIT 2035
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33713-9063
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1414 59TH ST S
Second Line :
City : GULFPORT
State : FL
Zip : 33707-3352
Country : US
Telephone Number : 727-344-4608
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2022
Last Update Date : 10/05/2022

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Directions to “ KENDALL MCCARDELL ” Practice Location

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