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Contact Information

KENISHA S PEMBERTON, MD
201 N CLYDE MORRIS BLVD
SUITE 200
DAYTONA BEACH, FL32114
 Phone: 386-254-4165
 Fax: 386-254-4339
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for KENISHA S PEMBERTON · (Female)

NPI Number 1114289907
Status Active
Credentials MD
Entity Individual
Enumeration date 06/08/2012
Last updated 06/14/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME117245
Hospital affiliation(s)
  • F F THOMPSON HOSPITAL - (Acute Care)
    350 PARRISH STREET
    CANANDAIGUA, NY 14424
  • STRONG MEMORIAL HOSPITAL - (Acute Care)
    601 ELMWOOD AVE
    ROCHESTER, NY 14642
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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