MEDICARE: SIGNATURE KEYS MEDICAL

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1902641244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGNATURE KEYS MEDICAL

Provider Business Mailing Address
First Line	:	3140 NORTHSIDE DR STE 201
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-8011
Country	:	US
Telephone Number	:	305-780-7489
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 NORTHSIDE DR STE 201
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-8011
Country	:	US
Telephone Number	:	305-780-7489
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE PRACTITIONER
Name	:	KEVIN LAWSON
Credential	:	ARNP
Telephone Number	:	305-780-7489

Provider Enumeration Date	:	06/27/2024
Last Update Date	:	06/27/2024

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Directions to “SIGNATURE KEYS MEDICAL ” Practice Location

Language	Start Address	Practice Location

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