Provider Demographics
NPI:1184792186
Name:KENNETH NESS, MD, PA
Entity type:Organization
Organization Name:KENNETH NESS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-655-8388
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 7000
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3404
Mailing Address - Country:US
Mailing Address - Phone:561-655-8388
Mailing Address - Fax:561-746-5198
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 7000
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-655-8388
Practice Address - Fax:561-746-5198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73980207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070234000Medicaid
FL070234000Medicaid
K6208Medicare PIN