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General NPI Number Information
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NPI Number | 1326465287
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Entity Type | Individual
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Provider Name | KENDRICK HEYWOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 3708 N OCEAN BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-6451
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Country | US
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Telephone | 954-909-4998
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Fax |
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Provider Business Mailing Address
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Address Line | 2920 NE 207TH ST STE 901
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City | MIAMI
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State | FL
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Zip | 33180-1444
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Country | US
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Telephone |
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Fax |
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME125373
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License Number State | FL
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