Healthcare Provider Details

I. General information

NPI: 1538190186
Provider Name (Legal Business Name): MURDOCK FAMILY MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19531 COCHRAN BLVD
PORT CHARLOTTE FL
33948-2081
US

IV. Provider business mailing address

19531 COCHRAN BLVD
PORT CHARLOTTE FL
33948-2081
US

V. Phone/Fax

Practice location:
  • Phone: 941-255-3535
  • Fax: 941-743-2121
Mailing address:
  • Phone: 941-255-3535
  • Fax: 941-743-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD E KENNEDY
Title or Position: PRESIDENT
Credential: DO
Phone: 941-255-3535