Healthcare Provider Details

I. General information

NPI: 1255475190
Provider Name (Legal Business Name): FLORIDA KIDZ AND FAMILIES MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 E 49TH ST
HIALEAH FL
33013-1904
US

IV. Provider business mailing address

11479 SW 40TH ST
MIAMI FL
33165-3311
US

V. Phone/Fax

Practice location:
  • Phone: 305-221-4994
  • Fax:
Mailing address:
  • Phone: 305-221-7235
  • Fax: 305-220-1847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH HERSHMAN
Title or Position: OWNER
Credential: M.D.
Phone: 305-221-7235