Urban, Kenneth J

Urban, Kenneth J is an individual health care provider with primary practice located at 1651 Se Tiffany Ave , Port St Lucie FL 34952-7564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Urban, Kenneth J can be contacted via phone (772) 398-1800.

Contact Information

Primary practice address
1651 Se Tiffany Ave Port St Lucie FL 34952-7564
Phone: (772) 398-1800
Fax: (772) 398-1815
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME33161 Florida

Profile Details

NPI number 1609884899
LBN Legal business name Urban, Kenneth J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jun 2nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609884899 NPPES
Florida MEDICAID 0372366600

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