Provider Demographics
NPI:1619166535
Name:KENDALL, WILLIAM FITZGERALD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FITZGERALD
Last Name:KENDALL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6006 49TH STREET NORTH
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2149
Mailing Address - Country:US
Mailing Address - Phone:727-527-9779
Mailing Address - Fax:727-522-0415
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3120
Practice Address - Country:US
Practice Address - Phone:727-587-7120
Practice Address - Fax:727-585-6850
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD8180208600000X
FLME100772208600000X, 204F00000X
NC2011-01105208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS105657Medicare PIN