Healthcare Provider Details

I. General information

NPI: 1619807112
Provider Name (Legal Business Name): DEXAFIT BROWARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9660 W SAMPLE RD STE 202
CORAL SPRINGS FL
33065-4041
US

IV. Provider business mailing address

9660 W SAMPLE RD STE 202
CORAL SPRINGS FL
33065-4041
US

V. Phone/Fax

Practice location:
  • Phone: 954-866-2193
  • Fax:
Mailing address:
  • Phone: 954-866-2193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN M KAMER JR.
Title or Position: OWNER
Credential: CSCS
Phone: 954-866-2193