Boerner, Kevin M

Boerner, Kevin M is an individual health care provider with primary practice located at 410 Celebration Place Suite 200, Celebration FL 34747-5432. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Boerner, Kevin M can be contacted via phone (407) 303-4673.

Contact Information

Primary practice address
410 Celebration Place Suite 200 Celebration FL 34747-5432
Phone: (407) 303-4673
Fax: (407) 398-0050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA1628 Florida

Profile Details

NPI number 1457346959
LBN Legal business name Boerner, Kevin M
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated Jan 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457346959 NPPES
Florida MEDICAID 290145500

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