Healthcare Provider Details

I. General information

NPI: 1811274996
Provider Name (Legal Business Name): KENDALL WOMAN CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11760 SW 40 STREET SUITE #518
MIAMI FL
33175
US

IV. Provider business mailing address

11760 SW 40 STREET SUITE #518
MIAMI FL
33175
US

V. Phone/Fax

Practice location:
  • Phone: 305-553-2888
  • Fax: 305-553-0291
Mailing address:
  • Phone: 305-553-2888
  • Fax: 305-553-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME108365
License Number StateFL

VIII. Authorized Official

Name: ADRIAN T MARIMON
Title or Position: MD.
Credential: MD.
Phone: 305-553-2888