Provider Demographics
NPI:1699948182
Name:KENNEDY, JOHN FRANCIS (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:KENNEDY
Suffix:
Gender:M
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11073 BRANDYWINE LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4889
Mailing Address - Country:US
Mailing Address - Phone:561-714-7332
Mailing Address - Fax:
Practice Address - Street 1:11073 BRANDYWINE LAKE WAY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33473-4889
Practice Address - Country:US
Practice Address - Phone:561-714-7332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10179225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist