Healthcare Provider Details

I. General information

NPI: 1265356380
Provider Name (Legal Business Name): KP HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 S APOLLO BLVD UNIT 101
MELBOURNE FL
32901-3146
US

IV. Provider business mailing address

1305 S APOLLO BLVD UNIT 101
MELBOURNE FL
32901-3146
US

V. Phone/Fax

Practice location:
  • Phone: 321-372-1055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KUSHAL PATEL
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 317-752-6978