Provider Demographics
NPI:1588643555
Name:WOZNIAK, KENNETH J (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:J
Last Name:WOZNIAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:561-712-6265
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:8150 CHANCELLOR DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7691
Practice Address - Country:US
Practice Address - Phone:407-587-4243
Practice Address - Fax:407-251-5053
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-10-12
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Provider Licenses
StateLicense IDTaxonomies
FLME32548207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD55011Medicare UPIN