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NPI Code Detail

MEDICARE: KENNETH L. MEREDITH M.D.

MEDICARE: KENNETH L. MEREDITH M.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
1208600000XSurgery PhysicianME102313FL
22086X0206XSurgical Oncology PhysicianME102313FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
252663OTHERFLBC/BS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659329217
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH L. MEREDITH M.D.
Provider Business Mailing Address
First Line : PO BOX 863407
Second Line :
City : ORLANDO
State : FL
Zip : 32886-3407
Country : US
Telephone Number : 941-917-2600
Fax Number : 941-917-7884
Provider Business Practice Location Address
First Line : 1950 ARLINGTON ST STE 101
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3508
Country : US
Telephone Number : 941-917-3400
Fax Number : 941-917-4300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 03/23/2021

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Directions to “ KENNETH L. MEREDITH M.D.” Practice Location

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