MEDICARE: DR. RICHARD C KERNISH MD

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	2085R0202X	Diagnostic Radiology Physician	33855	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	95533	OTHER	FL	BCBS FLORIDA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952378838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD C KERNISH MD

Provider Business Mailing Address
First Line	:	PO BOX 11398
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33339-1398
Country	:	US
Telephone Number	:	877-448-8675
Fax Number	:	770-666-9331

Provider Business Practice Location Address
First Line	:	3657 S MIAMI AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-4205
Country	:	US
Telephone Number	:	305-854-8317
Fax Number	:

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

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	06/27/2012

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Directions to “ DR. RICHARD C KERNISH MD” Practice Location

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