Provider Demographics
NPI:1891729034
Name:KEMP MEDICAL CENTER P A
Entity Type:Organization
Organization Name:KEMP MEDICAL CENTER P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-757-5340
Mailing Address - Street 1:150 N SYKES CREEK PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3488
Mailing Address - Country:US
Mailing Address - Phone:321-449-4537
Mailing Address - Fax:321-449-4573
Practice Address - Street 1:21 SUNTREE PL
Practice Address - Street 2:SUITE 101
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7600
Practice Address - Country:US
Practice Address - Phone:321-757-5340
Practice Address - Fax:321-757-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95053207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID NUMBER