MEDICARE: MICHAEL J KERKES MD

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	207Q00000X	Family Medicine Physician	ME44739	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00397528	OTHER		RR GBA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	593516436003	OTHER		TRICARE
2	7194953	OTHER		MAMSI
3	773114	OTHER		MAILHANDLERS
4	593516436	OTHER		MEDICAL MUTUAL
5	47696	OTHER	FL	BCBS
6	695956	OTHER		TUFTS

General Provider Information

NPI Number	:	1316943905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J KERKES MD

Provider Business Mailing Address
First Line	:	4614 S KIRKMAN RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-2891
Country	:	US
Telephone Number	:	407-512-5700
Fax Number	:	800-752-1493

Provider Business Practice Location Address
First Line	:	4614 S KIRKMAN RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-2891
Country	:	US
Telephone Number	:	407-512-5700
Fax Number	:	800-752-1493

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	12/13/2013

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