Provider Demographics
NPI:1477510311
Name:FOX, KEVIN BARUCH (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BARUCH
Last Name:FOX
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:12550 BISCAYNE BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2541
Mailing Address - Country:US
Mailing Address - Phone:305-608-6171
Mailing Address - Fax:
Practice Address - Street 1:12550 BISCAYNE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2541
Practice Address - Country:US
Practice Address - Phone:305-608-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE71196Medicare UPIN