| Divine Aging, LLC | |
|
2325 Ulmerton Rd Suite 19 Clearwater FL 33762-2282 | |
| (727) 271-1984 | |
| (727) 210-3036 |
| Full Name | Divine Aging, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2325 Ulmerton Rd, Clearwater, Florida |
| Authorized Official Name and Position | Parvinder S Kainth (OWNER) |
| Authorized Official Contact | 7272711984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Aging, LLC 2325 Ulmerton Rd Suite 19 Clearwater FL 33762-2282 Ph: (727) 271-1984 | Divine Aging, LLC 2325 Ulmerton Rd Suite 19 Clearwater FL 33762-2282 Ph: (727) 271-1984 |
| NPI Number | 1699147116 |
|---|---|
| Provider Enumeration Date | 10/23/2015 |
| Last Update Date | 10/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699147116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Florida) | Primary |
| 208D00000X | General Practice | () | Secondary |
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