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General NPI Number Information
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NPI Number | 1982007233
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Entity Type | Individual
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Provider Name | REBECCA MARIE KENNEDY HAS
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Gender | Female
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 3409 CLEVELAND HEIGHTS BLVD
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City | LAKELAND
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State | FL
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Zip | 33803-4807
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Country | US
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Telephone | 863-646-6663
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Fax | 863-709-9065
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Provider Business Mailing Address
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Address Line | 1888 PROSPECT AVENUE
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City | ORLANDO
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State | FL
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Zip | 32814
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Country | US
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Telephone |
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Fax | 407-286-3186
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AST366
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5093
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License Number State | FL
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