Healthcare Provider Details

I. General information

NPI: 1194553685
Provider Name (Legal Business Name): KALEY HOOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE ROAD BLDG E, SUITE C
SARASOTA FL
34233
US

IV. Provider business mailing address

3920 BEE RIDGE RD STE C BLDG E, SUITE C
SARASOTA FL
34233-1207
US

V. Phone/Fax

Practice location:
  • Phone: 941-306-1818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number29381
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: