Healthcare Provider Details

I. General information

NPI: 1487654042
Provider Name (Legal Business Name): KG HEALTH PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 142ND AVE N
CLEARWATER FL
33760-2822
US

IV. Provider business mailing address

6021 142ND AVE N
CLEARWATER FL
33760-2822
US

V. Phone/Fax

Practice location:
  • Phone: 727-796-6900
  • Fax:
Mailing address:
  • Phone: 727-796-6900
  • Fax: 727-669-8417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberHCC10003
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: BRYAN SCHMIDT
Title or Position: COO
Credential:
Phone: 727-796-6900