Healthcare Provider Details

I. General information

NPI: 1780306035
Provider Name (Legal Business Name): HUFFMAN & KERN VENTURES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 STATE ROAD 436 STE 1029
CASSELBERRY FL
32707-5479
US

IV. Provider business mailing address

853 STATE ROAD 436 STE 1029
CASSELBERRY FL
32707-5479
US

V. Phone/Fax

Practice location:
  • Phone: 407-960-3237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE KERN
Title or Position: C0-OWNER
Credential: DC
Phone: 386-451-5762