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NPI Code Detail

MEDICARE: KINSTEAD PROVIDER GROUP, P.A.

MEDICARE: KINSTEAD PROVIDER GROUP, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1568338473
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINSTEAD PROVIDER GROUP, P.A.
Provider Business Mailing Address
First Line : 2332 GALIANO ST FL 2
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-5402
Country : US
Telephone Number : 305-998-0546
Fax Number :
Provider Business Practice Location Address
First Line : 300 BAKER AVE STE 300
Second Line :
City : CONCORD
State : MA
Zip : 01742-2124
Country : US
Telephone Number : 305-998-0546
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. VIKRAM DEEPAK BAKHRU
Credential : MD
Telephone Number : 305-998-0546
Provider Enumeration Date : 10/16/2025
Last Update Date : 02/06/2026

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Directions to “KINSTEAD PROVIDER GROUP, P.A. ” Practice Location

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