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General NPI Number Information
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NPI Number | 1780708453
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Entity Type | Organization
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Legal Business Name | KENDALL NEUROLOGICAL SERVICES
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11760 SW 40TH ST SUITE 306
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-245-1774
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Fax | 305-245-1427
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Provider Business Mailing Address
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Address Line | 11760 SW 40TH ST SUITE 306
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-245-1774
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Fax | 305-245-1427
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Authorized Official
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Title or Position | CEO
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Name | DR. RICARDO GARCIA-RIVERA
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Credential | M.D.
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Telephone | 305-227-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME40533
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License Number State | FL
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