MEDICARE: FLORIDA KIDZ AND FAMILIES MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208000000X	Pediatrics Physician
3	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255475190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA KIDZ AND FAMILIES MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	11479 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3311
Country	:	US
Telephone Number	:	305-221-7235
Fax Number	:	305-220-1847

Provider Business Practice Location Address
First Line	:	551 E 49TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-1904
Country	:	US
Telephone Number	:	305-221-4994
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KENNETH HERSHMAN
Credential	:	M.D.
Telephone Number	:	305-221-7235

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	12/28/2011

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