Healthcare Provider Details

I. General information

NPI: 1447876131
Provider Name (Legal Business Name): JOSEPH SCOTT KENNEDY DNP, APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2020
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 POPE AVE NW
WINTER HAVEN FL
33881-4679
US

IV. Provider business mailing address

425 W COLONIAL DR STE 303
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 863-299-2630
  • Fax: 863-969-0711
Mailing address:
  • Phone: 321-332-6947
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11007644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: