Provider Demographics
NPI:1528591815
Name:GENDI, KIROLLOS (MD, MPH)
Entity Type:Individual
Prefix:
First Name:KIROLLOS
Middle Name:
Last Name:GENDI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 KANE CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2105
Mailing Address - Country:US
Mailing Address - Phone:305-674-2090
Mailing Address - Fax:305-674-2093
Practice Address - Street 1:1085 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2105
Practice Address - Country:US
Practice Address - Phone:305-674-2090
Practice Address - Fax:305-674-2093
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME155447207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program