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KERSENBROCK MEDICAL AND WELLNESS LLC NPI 1154816510


NPI Information

NPI: 1154816510
Provider Name: KERSENBROCK MEDICAL AND WELLNESS, LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
760 CURRENCY CIR STE A
LAKE MARY, FL
ZIP 32746
Phone: (407) 732-6920
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KERSENBROCK MEDICAL AND WELLNESS, LLC is a general practice in Lake Mary, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee KERSENBROCK MEDICAL AND WELLNESS, LLC NPI is 1154816510. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

760 CURRENCY CIR STE A
LAKE MARY, FL
ZIP 32746-138
Phone: (407) 732-6920
Fax: (407) 732-6923

The provider's authorized official is Benjamin Dale Kersenbrock .
The authorized official title is Owner and has the following contact phone number (407) 732-6920.

The enumeration date for this NPI number is 6/28/2018 and was last updated on 6/28/2018.


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
1208D00000XGeneral PracticeYes

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: 5/5/2024

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