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General NPI Number Information
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NPI Number | 1770945602
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Entity Type | Organization
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Legal Business Name | KEVIN B. FOX
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Dates
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Enumeration Date | 03/21/2016
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 7700 SW 104 STREET
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City | PINECREST
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State | FL
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Zip | 33156
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Country | US
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Telephone | 786-465-2900
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Fax | 305-595-1581
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Provider Business Mailing Address
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Address Line | 7700 SW 104 STREET
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City | PINECREST
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State | FL
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Zip | 33156
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Country | US
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Telephone | 786-465-2900
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Fax | 305-595-1581
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN BARUCH FOX
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Credential | D.O.
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Telephone | 786-465-2900
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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 | OS5562
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License Number State | FL
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