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General NPI Number Information
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NPI Number | 1326437302
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Entity Type | Organization
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Legal Business Name | KENNETH STRUBBE, MD, PA
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 7100 W 20TH AVE STE 314
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City | HIALEAH
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State | FL
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Zip | 33016-1811
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Country | US
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Telephone | 305-827-5890
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Fax | 305-827-5893
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Provider Business Mailing Address
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Address Line | 7100 W 20TH AVE STE 314
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City | HIALEAH
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State | FL
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Zip | 33016-1811
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Country | US
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Telephone | 305-827-5890
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Fax | 305-827-5893
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH STRUBBE
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Credential | MD
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Telephone | 305-495-5873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 75694
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License Number State | FL
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