DR. KENNETH W LONG MD NPI 1114971991

NPI Information

  • NPI: 1114971991
  • Provider Name: DR. KENNETH W LONG, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1395 EL RITO DR
    GULF BREEZE, FL
    ZIP 32563
  • Phone: (850) 932-9251

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NPI Details

DR. Kenneth W Long, MD is a family medicine in Gulf Breeze, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Kenneth W Long, MD NPI is 1114971991. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1395 EL RITO DR
GULF BREEZE, FL
ZIP 32563-707
Phone: (850) 932-9251
Fax: (850) 932-9199

The NPI 1114971991 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 2/21/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineME77376FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A92077MEDICARE UPINFLORIDA
249912MEDICARE ID-TYPE UNSPECIFIEDFLORIDA
3259005100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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