Provider Demographics
NPI:1427022458
Name:KENNEDY, KAREN THERESA (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:THERESA
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 GLENEAGLES DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4806
Mailing Address - Country:US
Mailing Address - Phone:561-699-2855
Mailing Address - Fax:866-628-5984
Practice Address - Street 1:40 S MAIN ST STE 1300
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-5513
Practice Address - Country:US
Practice Address - Phone:561-699-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6644207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology