JOHN EDWARD KIDDY MS ATC LAT CSCS NPI 1013172543

NPI Information

NPI: 1013172543
Provider Name: JOHN EDWARD KIDDY, MS, ATC, LAT, CSCS
Classification: Specialist/Technologist, Other - 246Z00000X
Entity Type: Individual
Address:
777 GLADES RD
BOCA RATON, FL
ZIP 33431
Phone: (561) 297-2043
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John Edward Kiddy, MS, ATC, LAT, CSCS is a specialist technologist other in Boca Raton, FL. The provider is general classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. John Edward Kiddy, MS, ATC, LAT, CSCS NPI is 1013172543. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

777 GLADES RD
BOCA RATON, FL
ZIP 33431-424
Phone: (561) 297-2043
Fax: (561) 297-0468

The enumeration date for this NPI number is 7/24/2008 and was last updated on 4/24/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246Z00000X	Specialist/Technologist, Other		AL2789	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03070219	OTHER		NATABOC CERTIFIED ATHLETIC TRAINER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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