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Kenneth Dye

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Kenneth Dye is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1093796229
Provider Type
Individual
Full Name
Dye, Kenneth
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
11/5/2005
Last Updated
9/1/2020

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA1505 Florida

Kenneth Dye

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Conley, Alana Estore

Harrell, Melanie Rose

Mccrary, Melissa

Gajarawala, Shilpa

Gajarawala, Nikunj

Henry, Tanisha M

Williams, Meredith

Miiller, Jennifer

Robinson, Eric

Salahshor, Susan