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General NPI Number Information
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NPI Number | 1033290291
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Entity Type | Organization
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Legal Business Name | KINETIC, INC.
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 4362 NORTHLAKE BLVD SUITE #202
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-6275
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Country | US
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Telephone | 561-630-4404
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Fax | 561-630-4373
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Provider Business Mailing Address
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Address Line | 4362 NORTHLAKE BLVD SUITE 202
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-6275
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Country | US
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Telephone | 561-630-4404
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Fax | 561-630-4373
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. H WAYNE SR.
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Credential |
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Telephone | 561-630-4404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1312880
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License Number State | FL
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