DR. KENDIS ARCHER (NPI# 1104031061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104031061 |
| Entity Type | Individual |
| Full Name | DR. KENDIS ARCHER |
| Credential | MD |
| Practice Address |
1506 Barcelona Ave Fort Pierce FL 34946 |
| Mailing Address |
220 Nw Bayshore Blvd Port Saint Lucie FL 34983-1504 |
| Practice Telephone | 7727089806 |
| Mailing Telephone | 7722918355 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2018-05-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ME125164 | FL | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 2010040907 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICAL LICENSE | 2010040907 | 01 |
| FL | MEDICAL LICENSE | ME125164 | 01 |
| Street Address |
1506 BARCELONA AVE |
| City | FORT PIERCE |
| State | FL |
| Zip Code | 34946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134617004 | Vision Scientific LLC | Clinical Medical Laboratory | 2286 N Us Highway 1, Fort Pierce, FL 34946 | 2018-04-26 |
| 1386730984 | Omniflight Helicopters, Inc. | Ambulance | 3105 Airmans Drive, Fort Pierce, FL 34946 | 2006-10-04 |
| 1154966687 | Shaquanda Parker | Nurse's Aide | 4989 Avienda Ave, Fort Pierce, FL 34946-1031 | 2019-11-07 |
| 1881259323 | Brendalin A Bacon | Counselor | 4713 El Nueva Ave, Fort Pierce, FL 34946-1035 | 2019-05-09 |
| 1679188916 | Yaisha Monique Sirmons | Massage Therapist | 4503 San Diego Ave, Fort Pierce, FL 34946-1055 | 2020-09-14 |
| 1972868990 | Duanda Clark | Occupational Therapist | 2401 Matanzas Ave, Fort Pierce, FL 34946-1165 | 2012-07-05 |
| 1215276845 | Rashandia Johnson | Case Manager/Care Coordinator | 2707 Walker Dr, Fort Pierce, FL 34946-1170 | 2013-02-01 |
| 1447443502 | Doris Monroe | Licensed Practical Nurse | 1807 Barcelona Ave, Fort Pierce, FL 34946-1321 | 2007-08-22 |
| 1821516899 | Nursing 360 LLC | Clinic/Center | 1504 Valencia Ave, Fort Pierce, FL 34946-1374 | 2017-08-30 |
| 1730723040 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 1851 N Us Highway 1, Fort Pierce, FL 34946-1406 | 2019-10-30 |
| Find all providers in zip 34946 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396166252 | M Care Medical Center Inc. | General Practice | 850 S 21st St, Suite B, Fort Pierce, FL 34950-4893 | 2013-12-19 |
| 1922363043 | Stanley Pala | General Practice | 4180 N Hwy A1a, #505, Fort Pierce, FL 34949-8380 | 2012-07-05 |
| 1538427984 | Eavans Duroseau | General Practice | 506 N 7th St, Fort Pierce, FL 34950-8228 | 2012-04-23 |
| 1679665814 | Juan D. Maldonado | General Practice | 1404 S 28th St, Fort Pierce, FL 34947-6999 | 2006-09-28 |
| 1396171633 | Sarang Hadaegh | General Practice | 1505 Delaware Ave, Fort Pierce, FL 34950-3975 | 2013-09-18 |
| 1538439559 | Chacko Nebu | General Practice | 2401 Frist Boulevard, Suite One, Fort Pierce, FL 34950 | 2012-01-06 |
| 1861788036 | Tj Medical LLC | General Practice | 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 | 2011-06-25 |
| 1316233588 | Fp Medical | General Practice | 1905 S 25th St, Suite 100, Fort Pierce, FL 34947-4739 | 2011-06-25 |
| 1952547721 | Guillermo G Coquelet | General Practice | 4640 S 25th St, Fort Pierce, FL 34981-5057 | 2008-12-30 |
| 1184753758 | Fort Pierce Intermediate Care Center | General Practice | 900 Virginia Ave, Suite 10, Fort Pierce, FL 34982-5882 | 2007-03-02 |
| Find all providers in FORT PIERCE | ||||
| City | FORT PIERCE |
| Zip Code | 34946 |
Please comment or provide details below to improve the information on DR. KENDIS ARCHER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.