Healthcare Provider Details

I. General information

NPI: 1982296737
Provider Name (Legal Business Name): KINDBODY OF FL MEDICAL PRACTICE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 CELEBRATION BLVD STE 200
CELEBRATION FL
34747-5165
US

IV. Provider business mailing address

120 5TH AVE FL 5
NEW YORK NY
10011-5638
US

V. Phone/Fax

Practice location:
  • Phone: 855-563-2639
  • Fax:
Mailing address:
  • Phone: 855-563-2639
  • Fax: 646-905-0987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FAHIMEH SASAN
Title or Position: FOUNDING OBGYN
Credential: DO
Phone: 855-563-2639