Provider Demographics
NPI:1104871193
Name:M. ELENA KENDALL MD PA
Entity type:Organization
Organization Name:M. ELENA KENDALL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:305-446-2121
Mailing Address - Street 1:356 ALHAMBRA CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-446-2121
Mailing Address - Fax:305-856-4363
Practice Address - Street 1:356 ALHAMBRA CIRCLE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-446-2121
Practice Address - Fax:305-856-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95887Medicare ID - Type UnspecifiedPROVIDER NUMBER
FLFL71900Medicare UPIN