DR. ROBERT KENNEDY (NPI# 1740220789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740220789 |
| Entity Type | Individual |
| Full Name | DR. ROBERT KENNEDY |
| Credential | MD |
| Practice Address |
415 S Wickham Rd West Melbourne FL 32904-1137 |
| Mailing Address |
2200 W Eau Gallie Blvd 200 Melbourne FL 32935-3165 |
| Practice Telephone | 3214001220 |
| Practice Fax Number | 3212413000 |
| Mailing Telephone | 3212532900 |
| Mailing Fax Number | 3214350100 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2015-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
ME81880 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 273810400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893098 | Robert Dale Kennedy | Technician | 460 Mitchell Branch, Red Jacket, WV 25692 | 2020-08-26 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1588119481 | Robert Kennedy | Counselor | 313 W Valencia St, Lakeland, FL 33805-3138 | 2016-08-20 |
| 1538549514 | Robert Kennedy | Physical Therapy Assistant | 300 Seville Road, Hurricane, WV 25526 | 2015-06-04 |
| 1780096040 | Robert Kennedy IIi | Social Worker | 654 Jones Ln, Dublin, GA 31021-0303 | 2014-05-21 |
| 1134492481 | Robert S Kennedy | Pharmacist | 3551 Roger Brooke Dr # Drive, Jbsa Ft Sam Houston, TX 78234-4504 | 2012-02-17 |
| 1215163142 | Robert Edward Kennedy | Psychoanalyst | 50 Greenwood Ave, Jersey City, NJ 07306 | 2009-06-05 |
| 1134379415 | Robert Joseph Kennedy | Physical Therapist | 155 Bryant Ave, Glen Ellyn, IL 60137-5523 | 2008-09-24 |
| 1063691889 | Robert Leslie Kennedy | Pharmacist | 1735 Scherm Rd, Owensboro, KY 42301-5972 | 2007-10-29 |
| 1578635926 | Robert M Kennedy | Dentist | 200 The Great Road, Suite 243, Bedford, MA 01730 | 2006-11-14 |
| Street Address |
415 S WICKHAM RD |
| City | WEST MELBOURNE |
| State | FL |
| Zip Code | 32904-1137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205481488 | Nickline Clervil Emile | Family Medicine | 415 S Wickham Rd, West Melbourne, FL 32904-1137 | 2019-08-05 |
| 1174980973 | Interventional & Vascular Center, Pllc | Radiology | 415 S Wickham Rd, West Melbourne, FL 32904-1137 | 2016-01-25 |
| 1790703213 | Brian L Dunfee | Radiology | 415 S Wickham Rd, West Melbourne, FL 32904-1137 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174980973 | Interventional & Vascular Center, Pllc | Radiology | 415 S Wickham Rd, West Melbourne, FL 32904-1137 | 2016-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100917 | Emergency and Interventional Specialists, Inc | Radiology | 5626 Gulf Dr Ste 100, New Port Richey, FL 34652-4020 | 2020-09-23 |
| 1548879794 | Vascular Specialist of Venice and Sarasota Pl | Radiology | 6600 University Parkway, #102, Sarasota, FL 34240 | 2020-07-23 |
| 1164060497 | Advanced Vascular Cardiac & Veins, Pllc | Radiology | 7480 Bird Rd Ste 560, Miami, FL 33155-6657 | 2019-12-17 |
| 1801437041 | Premier Interventional & Diagnostic Radiology, Corp | Radiology | 8495 Sw 56th St, Miami, FL 33155-5426 | 2019-09-30 |
| 1003476169 | Hss-florida Physicians LLC | Radiology | 1395 S State Road 7 Ste 410, Wellington, FL 33414-9327 | 2019-06-19 |
| 1003302712 | Ocuflow Doppler LLC | Radiology | 1855 Veterans Park Drive, Naples, FL 34109 | 2018-07-05 |
| 1972006351 | Minimally Invasive Vascular, Inc | Radiology | 2720 Us Highway 1 S Ste C, St Augustine, FL 32086-6301 | 2018-03-13 |
| 1124530761 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 313 W Bass St, Kissimmee, FL 34741-5011 | 2017-11-03 |
| 1942727516 | Inspired Interventional Radiology Services LLC | Radiology | 11011 Sheridan St Ste 102, Hollywood, FL 33026-1501 | 2017-08-24 |
| 1386004901 | Precision Medical Imaging and Therapeutic Institute LLC | Radiology | 2540 Green Forest Ln, Suite #101, Lutz, FL 33558-5388 | 2016-02-24 |
| Find all providers with the same taxonomy | ||||
| City | WEST MELBOURNE |
| Zip Code | 32904 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.