Healthcare Provider Details

I. General information

NPI: 1568898286
Provider Name (Legal Business Name): NATALIE KENTON CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2013
Last Update Date: 09/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 S CONGRESS AVE SUITE 13
BOYNTON BEACH FL
33426-8424
US

IV. Provider business mailing address

3800 S CONGRESS AVE SUITE 13
BOYNTON BEACH FL
33426-8424
US

V. Phone/Fax

Practice location:
  • Phone: 561-733-6665
  • Fax: 561-733-6663
Mailing address:
  • Phone: 561-733-6665
  • Fax: 561-733-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberRPT 19246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: