| Doctor Name: | DR. KENDIS ARCHER |
| NPI Number: | 1104031061 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 2010040907 |
| Business Practice Address: | 3625 F C I Rd Marianna, FL - 324467917 |
| Business Phone Number: | 8505262032 |
| Business Fax Number: | |
| Mailing Address: | 220 Nw Bayshore Blvd, PORT SAINT LUCIE |
| State: | FL |
| Postal Code: | 349831504 |
| Phone Number: | 7722918355 |
| Fax Number: | |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2010040907 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |