Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kerry Diane Thek, MD

Individual provider Pediatric Gastroenterology Physician · NPI 1457349417

Dr. Kerry Diane Thek, MD is a Pediatric Gastroenterology Physician in Port Orange, Florida. Licensed in Arkansas and Florida. Registered with an NPI since 2005.

Licensed in
AR, FL
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1690 Dunlawton Ave Ste 120
Port Orange, FL 32127-8980
Phone: (386) 677-0531
Fax: (386) 673-4658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Gastroenterology Physician (primary) Taxonomy 2080P0206X · Licence ME58396 (FL)
Pediatric Gastroenterology Physician Taxonomy 2080P0206X · Licence E-11212 (AR)

Record details

NPI number1457349417
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 12, 2005
Last updated in NPPESMay 23, 2018