Derbenwick, Kenneth

Derbenwick, Kenneth is an individual health care provider with primary practice located at 350 N Clyde Morris Blvd , Daytona Beach FL 32114. He recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as his primary health care specialty. Derbenwick, Kenneth can be contacted via phone (386) 238-3200.

Contact Information

Primary practice address
350 N Clyde Morris Blvd Daytona Beach FL 32114
Phone: (386) 238-3200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X ME0026485 Florida

Profile Details

NPI number 1366402562
LBN Legal business name Derbenwick, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jul 8th, 2007 - about 18 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 1366402562 NPPES
Florida Other ME0026485 VHN
Florida Other ME0026485 VHN

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