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General NPI Number Information
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NPI Number | 1205927373
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Entity Type | Individual
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Provider Name | JAIME L KEAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6166 SEMINOLE BLVD
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City | SEMINOLE
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State | FL
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Zip | 33772-6835
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Country | US
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Telephone | 727-391-0715
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Fax | 727-391-7251
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Provider Business Mailing Address
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Address Line | 200 4TH AVE S APT 326
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4395
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Country | US
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Telephone | 727-421-8272
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Fax | 727-391-7251
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8775
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License Number State | FL
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