| Organization Name: | KENBECK LLC |
| NPI Number: | 1437286937 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SOFIYA JOHNSON (PRESIDENT) |
| Mailing Address: | 4342 E Tradewinds Ave Lauderdale By The Sea |
| State: | FL US |
| Postal Code: | 333085044 |
| Phone Number: | 9544913103 |
| Fax Number: | 9544913105 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 170100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Medical Genetics, Ph.D. Medical Genetics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |