Provider Demographics
NPI:1033235999
Name:KENOL, CLAUDE J (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:J
Last Name:KENOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1044 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5603
Mailing Address - Country:US
Mailing Address - Phone:239-298-8167
Mailing Address - Fax:239-649-0120
Practice Address - Street 1:3715 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6222
Practice Address - Country:US
Practice Address - Phone:239-793-6434
Practice Address - Fax:239-793-2184
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME74930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44586OtherBCBS FL