| Kenneth B Shephard Md Pa | |
|
8700 N Kendall Dr Ste 102 Miami FL 33176-2206 | |
| (305) 273-1919 | |
| (305) 273-1929 |
| Full Name | Kenneth B Shephard Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 8700 N Kendall Dr Ste 102, Miami, Florida |
| Authorized Official Name and Position | Ann Theisen (ACCT) |
| Authorized Official Contact | 7864753971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth B Shephard Md Pa 8700 N Kendall Dr Ste 102 Miami FL 33176-2206 Ph: (305) 273-1919 | Kenneth B Shephard Md Pa 8700 N Kendall Dr Ste 102 Miami FL 33176-2206 Ph: (305) 273-1919 |
| NPI Number | 1780078477 |
|---|---|
| Provider Enumeration Date | 03/20/2015 |
| Last Update Date | 08/23/2024 |
| Medicare PECOS PAC ID | 5193109023 |
|---|---|
| Medicare Enrollment ID | O20220826000805 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780078477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
| Provider Name | Kenneth B Shephard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568411262 PECOS PAC ID: 7719904754 Enrollment ID: I20051028000290 |
| Provider Name | Irina C. Delgado-varela |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558673368 PECOS PAC ID: 1951648054 Enrollment ID: I20191016003262 |
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