Provider Demographics
NPI:1043241284
Name:KENDALL REGIONAL MEDICAL SERVICES
Entity type:Organization
Organization Name:KENDALL REGIONAL MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABELOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACP
Authorized Official - Phone:305-279-7992
Mailing Address - Street 1:11440 N KENDALL DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1044
Mailing Address - Country:US
Mailing Address - Phone:305-412-5535
Mailing Address - Fax:
Practice Address - Street 1:11440 N KENDALL DR
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1044
Practice Address - Country:US
Practice Address - Phone:305-412-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD59044Medicare UPIN
FL90087CMedicare ID - Type UnspecifiedMEDICAL DIRECTOR PROVIDER
FLK7679Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER