Provider Demographics
NPI:1205807609
Name:INWOOD, KEVIN D (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:INWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3241 EXECUTIVE WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3931
Mailing Address - Country:US
Mailing Address - Phone:561-985-6500
Mailing Address - Fax:561-967-8419
Practice Address - Street 1:641 UNIVERSITY BLVD STE 202
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2794
Practice Address - Country:US
Practice Address - Phone:561-745-7311
Practice Address - Fax:561-745-9501
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0052081207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040906700Medicaid
FL040906700Medicaid
FL07537YMedicare ID - Type Unspecified