MEDICARE: KENNEDY MURRIAN

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
1	235Z00000X	Speech-Language Pathologist	SA23546	FL

General Provider Information

NPI Number	:	1023808276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNEDY MURRIAN

Provider Business Mailing Address
First Line	:	3530 1ST AVE N STE 120
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-8441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 1ST AVE N STE 120
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-8441
Country	:	US
Telephone Number	:	407-271-4911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2025
Last Update Date	:	05/10/2025

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Directions to “ KENNEDY MURRIAN ” Practice Location

Language	Start Address	Practice Location

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