Healthcare Provider Details

I. General information

NPI: 1992633358
Provider Name (Legal Business Name): KAYEMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 GRAND RESERVE DR
DAVENPORT FL
33837-5204
US

IV. Provider business mailing address

8297 CHAMPIONS GATE BLVD STE 315
CHAMPIONS GATE FL
33896-8387
US

V. Phone/Fax

Practice location:
  • Phone: 321-420-7117
  • Fax: 407-537-6100
Mailing address:
  • Phone: 321-420-7117
  • Fax: 407-537-6100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KAREEN KAYE EVANS
Title or Position: OWNER
Credential: FNP-C
Phone: 321-420-7117