Bruce S Kennedy MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0043975 Issued in FL

Legal business name

BRUCE S KENNEDY MD PA

Practice address

411 Lakebridge Plaza Dr
Suite B
Ormond Beach, FL 32174-5157

Phone

(386) 673-2547

Fax

(386) 673-6141

NPI assigned

May 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce S Kennedy, MD

Title

President

Phone

(386) 673-2547

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841240678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 LAKEBRIDGE PLAZA DR",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-673-2547",
            "fax_number": "386-673-6141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAKEBRIDGE PLAZA DR",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "386-673-2547",
            "fax_number": "386-673-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE S KENNEDY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-673-2547",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0043975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02516",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James William Brown, MD
• Lana Esther Brown, L.M.H.C., L.C.P.C.
• Norman Malcolm Brown, PH.D., LMFT
• Richard Stephen Brown, DMD, PA
• Teresa Jean Brown, LCSW
• Rebecca Ann Bruno, DC
• David Bruton, DO
• Melanee Christina Bryans, HIS
• Kimberly Bryant
• Anniel Buchanan

• Specialist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.