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General NPI Number Information
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NPI Number | 1568338473
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Entity Type | Organization
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Legal Business Name | KINSTEAD PROVIDER GROUP, P.A.
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 2332 GALIANO ST FL 2
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City | CORAL GABLES
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State | FL
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Zip | 33134-5402
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Country | US
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Telephone | 305-998-0546
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Fax |
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Provider Business Mailing Address
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Address Line | 2332 GALIANO ST FL 2
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City | CORAL GABLES
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State | FL
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Zip | 33134-5402
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Country | US
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Telephone | 305-998-0546
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIKRAM DEEPAK BAKHRU
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Credential | MD
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Telephone | 305-998-0546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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