Healthcare Provider Details

I. General information

NPI: 1770029225
Provider Name (Legal Business Name): KARLYNE KENNY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 DRANE FIELD RD
LAKELAND FL
33811-1259
US

IV. Provider business mailing address

200 AVENUE F NE
WINTER HAVEN FL
33881-4131
US

V. Phone/Fax

Practice location:
  • Phone: 407-214-5856
  • Fax: 833-410-2620
Mailing address:
  • Phone: 863-293-1121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025073943
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1846562
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: