Provider Demographics
NPI:1396854956
Name:PRESSLEY, KEVIN LEE (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:LEE
Last Name:PRESSLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4474 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1216
Mailing Address - Country:US
Mailing Address - Phone:407-297-8007
Mailing Address - Fax:407-297-0006
Practice Address - Street 1:4474 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1216
Practice Address - Country:US
Practice Address - Phone:407-297-8007
Practice Address - Fax:407-297-0006
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0006388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE91578Medicare UPIN
FL80677Medicare PIN