Provider Demographics
NPI:1356721724
Name:KERNS, AILEEN KATHERINE (DO)
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:KATHERINE
Last Name:KERNS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AILEEN
Other - Middle Name:KATHERINE
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9212 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2924
Mailing Address - Country:US
Mailing Address - Phone:203-241-1951
Mailing Address - Fax:
Practice Address - Street 1:3501 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5421
Practice Address - Country:US
Practice Address - Phone:954-987-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA291638207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology