Provider Demographics
NPI:1922161256
Name:KENDALL THERAPEUTICS INC
Entity Type:Organization
Organization Name:KENDALL THERAPEUTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAQUELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:USAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-860-8181
Mailing Address - Street 1:1330 CORAL WAY
Mailing Address - Street 2:#200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2929
Mailing Address - Country:US
Mailing Address - Phone:305-860-8181
Mailing Address - Fax:
Practice Address - Street 1:1330 CORAL WAY
Practice Address - Street 2:#200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2929
Practice Address - Country:US
Practice Address - Phone:305-860-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
684830Medicare Oscar/Certification