MEDICARE: DR. MARY RATLIFF KEDROWSKI D.O.

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	208600000X	Surgery Physician	OS15936	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629483508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY RATLIFF KEDROWSKI D.O.

Provider Business Mailing Address
First Line	:	3140 NW MEDICAL CENTER LN STE 120
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-4735
Country	:	US
Telephone Number	:	386-755-6682
Fax Number	:	386-755-6796

Provider Business Practice Location Address
First Line	:	3140 NW MEDICAL CENTER LN
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-4717
Country	:	US
Telephone Number	:	386-755-6682
Fax Number	:	386-755-6796

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

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	02/27/2023

Similar Medicare Providers

1710971460 — MR. EDWIN GONZALEZ-NAVEDO MD
Practice Location Address:

3140 NW MEDICAL CENTER LN , SUITE 120
LAKE CITY, FL
32055-4717

Practice Phone: 386-755-6682
Practice Fax: 386-755-6796

1205821683 — DR. ALEJANDRO T SOLER MD
Practice Location Address:

3140 NW MEDICAL CENTER LN , SUITE 120
LAKE CITY, FL
32055-4717

Practice Phone: 386-755-6682
Practice Fax: 386-755-6796

1104868413 — GATEWAY SURGICAL GROUP LLC
Practice Location Address:

3140 NW MEDICAL CENTER LN , SUITE 120
LAKE CITY, FL
32055-4717

Practice Phone: 386-755-6682
Practice Fax: 386-755-6796

1295038115 — LAKE CITY IMAGING LLC
Practice Location Address:

3140 NW MEDICAL CENTER LN , SUITE 100
LAKE CITY, FL
32055-4717

Practice Phone: 386-755-2020
Practice Fax: 386-755-0690

1811294481 — INFECTIOUS DISEASES CONSULTANTS MADHURI SANKURATRI MD LLC
Practice Location Address:

3140 NW MEDICAL CENTER LN , STE 120
LAKE CITY, FL
32055-4717

Practice Phone: 352-213-6722
Practice Fax:

1386659530 — WALGREEN CO
Practice Location Address:

2002 MISSOURI BLVD
JEFFERSON CITY, MO
65109-4717

Practice Phone: 573-636-7924
Practice Fax:

Directions to “ DR. MARY RATLIFF KEDROWSKI D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.