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Contact Information

SANDFORD H KINNE III, DO
290 CLYDE MORRIS BLVD
SUITE A-1
ORMOND BEACH, FL32174
 Phone: 386-677-5600
 Fax: 386-677-5686
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SANDFORD H KINNE III · (Male)

NPI # 1043328735
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/25/2006
Last updated 04/21/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • FL License # OS0006791
  • FL Medicaid 013379100
  • FL Other 58722 AETNA
  • FL Other 593573926 TRICARE HUMANA
Hospital affiliation(s)
  • FLORIDA HOSPITAL FLAGLER - (Acute Care)
    60 MEMORIAL MEDICAL PKWY
    PALM COAST, FL 32164
  • FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER - (Acute Care)
    301 MEMORIAL MEDICAL PARKWAY
    DAYTONA BEACH, FL 32117
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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