Provider Demographics
NPI:1205808516
Name:BARON, KENNETH JOSEPH (PA-C)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:JOSEPH
Last Name:BARON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3250 ZEMKE AVE #1078
Mailing Address - Street 2:6TH MEDICAL GROUP
Mailing Address - City:MACDILL AFB
Mailing Address - State:FL
Mailing Address - Zip Code:33621
Mailing Address - Country:US
Mailing Address - Phone:138-827-9650
Mailing Address - Fax:813-827-9099
Practice Address - Street 1:3250 ZEMKE AVE #1078
Practice Address - Street 2:6TH MEDICAL GROUP
Practice Address - City:MACDILL AFB
Practice Address - State:FL
Practice Address - Zip Code:33621
Practice Address - Country:US
Practice Address - Phone:138-827-9650
Practice Address - Fax:813-827-9099
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2025-01-09
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Provider Licenses
StateLicense IDTaxonomies
FLPA 3692363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical