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General NPI Number Information
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NPI Number | 1548101686
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Entity Type | Individual
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Provider Name | LAKESHIA RENEE KENNEDY
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 3500 N STATE ROAD 7 STE 302
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5626
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Country | US
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Telephone | 954-557-9264
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 N STATE ROAD 7 STE 302
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5626
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Country | US
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Telephone | 954-557-9264
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 75768402
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 20-0191Y10
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License Number State | FL
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