Provider Demographics
NPI:1891375226
Name:HAWKINS, KENNETH B II
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:B
Last Name:HAWKINS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15424 PLANTATION OAKS DR APT 7
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2123
Mailing Address - Country:US
Mailing Address - Phone:816-284-9058
Mailing Address - Fax:
Practice Address - Street 1:15424 PLANTATION OAKS DR APT 7
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2123
Practice Address - Country:US
Practice Address - Phone:816-284-9058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-157042106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician