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General NPI Number Information
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NPI Number | 1053739680
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Entity Type | Organization
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Legal Business Name | KENT CLINIC, LLC
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 2116 S ORANGE AVE SUITE B
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City | ORLANDO
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State | FL
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Zip | 32806-3037
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Country | US
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Telephone | 407-704-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 S ORANGE AVE SUITE B
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City | ORLANDO
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State | FL
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Zip | 32806-3037
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Country | US
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Telephone | 407-704-8990
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ZAHRA KENT
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Credential |
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Telephone | 407-704-8990
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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 | 7198550001
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | OS12315
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License Number State | FL
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