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General NPI Number Information
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NPI Number | 1861699977
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Entity Type | Individual
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Provider Name | KEVIN E O'KEEFE PSYD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1962 VANDOLAH RD
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City | WAUCHULA
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State | FL
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Zip | 33873-8726
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Country | US
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Telephone | 800-697-5390
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Fax | 863-773-9293
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Provider Business Mailing Address
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Address Line | 3414 29TH ST E
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City | BRADENTON
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State | FL
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Zip | 34208-7310
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Country | US
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Telephone | 941-748-3660
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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 | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | PY 5898
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License Number State | FL
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