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NPI Code Detail

MEDICARE: KBS MEDICAL PA

MEDICARE: KBS MEDICAL PA
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
1208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1710865993
Entity Type Code : Organization
Provider Name (Legal Business Name) : KBS MEDICAL PA
Provider Business Mailing Address
First Line : 169 MADISON AVE STE 15824
Second Line :
City : NEW YORK
State : NY
Zip : 10016-5101
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3350 SW 148TH AVE STE 110
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-3237
Country : US
Telephone Number : 909-442-4965
Fax Number :
Authorized Official
Title or Position : COO
Name : LISA KENNEDY
Credential :
Telephone Number : 909-679-3482
Provider Enumeration Date : 08/25/2025
Last Update Date : 02/18/2026

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Directions to “KBS MEDICAL PA ” Practice Location

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