Basic Information
| Provider Information | |||||||||
| NPI: | 1912233743 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL KESDEN MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4850 W OAKLAND PARK BLVD | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333137260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544844440 | ||||||||
| FaxNumber: | 9544849250 | ||||||||
| Practice Location | |||||||||
| Address1: | 4850 W OAKLAND PARK BLVD | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333137260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544844440 | ||||||||
| FaxNumber: | 9544849250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2009 | ||||||||
| LastUpdateDate: | 10/29/2009 | ||||||||
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| AuthorizedOfficialLastName: | KESDEN | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9544844440 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | ME0024347 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.