Healthcare Provider Details

I. General information

NPI: 1871207126
Provider Name (Legal Business Name): HUFFMAN AND KERN VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 STATE ROAD 436 STE AND1035
CASSELBERRY FL
32707-5342
US

IV. Provider business mailing address

853 STATE ROAD 436 STE AND1035
CASSELBERRY FL
32707-5342
US

V. Phone/Fax

Practice location:
  • Phone: 407-951-7123
  • Fax: 407-951-7529
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE N KERN
Title or Position: MANAGING PARTNER
Credential: DC
Phone: 407-960-3237