Provider Demographics
NPI:1457306607
Name:KENSELL, RALPH F (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:F
Last Name:KENSELL
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 1:511 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-7326
Mailing Address - Country:US
Mailing Address - Phone:352-728-6808
Mailing Address - Fax:352-728-1743
Practice Address - Street 1:201 LAGRANDE BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-1303
Practice Address - Country:US
Practice Address - Phone:352-753-0606
Practice Address - Fax:352-365-1003
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAK1551921207P00000X
FLME 111235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3848984Medicaid
TN3848983Medicaid
TN930003976OtherRAILROAD MEDICAE
TN3076448OtherBLUE CROSS
TN0161833OtherBLUE CROSS
TN3848984Medicaid
TN3848983Medicare PIN
FLFN228ZMedicare PIN