Healthcare Provider Details
I. General information
NPI: 1548125792
Provider Name (Legal Business Name): KENDALL PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13500 SW 88TH ST STE 287C
MIAMI FL
33186-1528
US
IV. Provider business mailing address
16603 SW 97TH ST
MIAMI FL
33196-5856
US
V. Phone/Fax
- Phone: 786-541-0730
- Fax:
- Phone: 786-541-0730
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROSSANA
LOPEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 786-541-0730