Provider Demographics
NPI:1144258724
Name:KERDEL, FRANCISCO A (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:A
Last Name:KERDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NW 12TH AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1003
Mailing Address - Country:US
Mailing Address - Phone:305-324-2110
Mailing Address - Fax:305-325-0919
Practice Address - Street 1:1400 NW 12TH AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1003
Practice Address - Country:US
Practice Address - Phone:305-324-2110
Practice Address - Fax:305-325-0919
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50029207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045067700Medicaid
FL045067700Medicaid
FLA61734Medicare UPIN