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General NPI Number Information
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NPI Number | 1619137106
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Entity Type | Individual
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Provider Name | KEVIN PARKER MD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 2598 E SUNRISE BLVD STE 2104
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City | FT LAUDERDALE
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State | FL
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Zip | 33304-3230
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Country | US
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Telephone | 202-302-4864
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Fax |
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Provider Business Mailing Address
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Address Line | 2598 E SUNRISE BLVD STE 2104
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City | FT LAUDERDALE
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State | FL
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Zip | 33304-3230
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 921189
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME121999
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01089698A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | EMC0005267
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | ME121999
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License Number State | FL
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