MEDICARE: CALEB JOSEPH KENNEDY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4146	FL
2	152W00000X	Optometrist	004146	FL

General Provider Information

NPI Number	:	1205064334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB JOSEPH KENNEDY O.D.

Provider Business Mailing Address
First Line	:	18503 PINES BLVD STE 205
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-1405
Country	:	US
Telephone Number	:	954-430-8330
Fax Number	:	954-430-3638

Provider Business Practice Location Address
First Line	:	18503 PINES BLVD STE 205
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-1405
Country	:	US
Telephone Number	:	954-430-8330
Fax Number	:	954-430-3638

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2009
Last Update Date	:	06/18/2020

Similar Medicare Providers

1467383372 — VICTORIA MOLINA DMD
Practice Location Address:

18503 PINES BLVD STE 208
PEMBROKE PINES, FL
33029-1405

Practice Phone: 954-499-0033
Practice Fax:

1376530196 — MARTHA L MAYORGA-VASQUEZ MD
Practice Location Address:

18503 PINES BLVD STE 212
PEMBROKE PINES, FL
33029-1405

Practice Phone: 954-392-0266
Practice Fax: 954-392-0267

1962563395 — HELEN MARGARET SALSBURY M.D,
Practice Location Address:

18503 PINES BLVD STE 211
PEMBROKE PINES, FL
33029-1405

Practice Phone: 954-436-2867
Practice Fax: 954-442-5167

1104167345 — KENNEDY VISION PA
Practice Location Address:

18503 PINES BLVD STE 205
PEMBROKE PINES, FL
33029-1405

Practice Phone: 954-430-8330
Practice Fax: 954-430-3638

1336519693 — M & M PEDIATRICS P.A.
Practice Location Address:

18503 PINES BLVD STE 212
PEMBROKE PINES, FL
33029-1405

Practice Phone: 954-392-0266
Practice Fax: 954-392-0267

1063952372 — GABRIELA MOLINA DDS
Practice Location Address:

18503 PINES BLVD STE 208
PEMBROKE PINES, FL
33029-1405

Practice Phone: 954-499-0033
Practice Fax: 954-499-0355

Directions to “ CALEB JOSEPH KENNEDY O.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.