Healthcare Provider Details

I. General information

NPI: 1356195846
Provider Name (Legal Business Name): KAIWELL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15321 S DIXIE HWY STE 203
MIAMI FL
33157-1814
US

IV. Provider business mailing address

15321 S DIXIE HWY STE 203
PALMETTO BAY FL
33157-1814
US

V. Phone/Fax

Practice location:
  • Phone: 786-707-4934
  • Fax: 845-250-0029
Mailing address:
  • Phone: 305-707-4394
  • Fax: 845-250-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LIZAIDA ENAMORADO
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 305-707-4394