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General NPI Number Information
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NPI Number | 1437730926
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Entity Type | Individual
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Provider Name | KENAZ TALEB MD
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Gender | Female
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3450 11TH CT STE 201
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City | VERO BEACH
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State | FL
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Zip | 32960-5012
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Country | US
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Telephone | 772-794-3364
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Fax |
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Provider Business Mailing Address
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Address Line | 1471 WHITMAN DR
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-8755
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Country | US
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Telephone | 321-417-4737
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME169017
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License Number State | FL
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