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General NPI Number Information
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NPI Number | 1184849226
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Entity Type | Organization
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Legal Business Name | KENDALL NEUROLOGICAL INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11760 BIRD ROAD SUITE 306
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-245-1774
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Fax |
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Provider Business Mailing Address
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Address Line | 11760 BIRD ROAD SUITE 306
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City | MIAMI
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State | FL
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Zip | 33175
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Country | US
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Telephone | 305-245-1774
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICARDO GARCIA-RIVERA
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Credential | M.D.
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Telephone | 305-245-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME40533
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME82397
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License Number State | FL
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