Provider Demographics
NPI:1356867048
Name:BRYANT, KENDALL ATHER (PHD D)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:ATHER
Last Name:BRYANT
Suffix:
Gender:M
Credentials:PHD D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2216
Mailing Address - Country:US
Mailing Address - Phone:402-681-9757
Mailing Address - Fax:
Practice Address - Street 1:520 BAKER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2216
Practice Address - Country:US
Practice Address - Phone:402-681-9757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDI44696247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician