Healthcare Provider Details

I. General information

NPI: 1235523994
Provider Name (Legal Business Name): DANIEL KEMP PAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 HOVEY RD
PENSACOLA FL
32508-1044
US

IV. Provider business mailing address

220 HOVEY RD
PENSACOLA FL
32508-1044
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-6598
  • Fax:
Mailing address:
  • Phone: 619-532-6598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1125491
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: