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Organization
KNEAD TO BE FIT, INC
Active
Organization
KNEAD TO BE FIT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE KINGSTON (COO)
(321) 251-7877
Entity
Organization
Contact information
Practice address
3160 SOUTHGATE COMMERCE BLVD, SUITE 38B, ORLANDO, FL 32806-8549
(321) 251-7877
(321) 206-8212
Mailing address
3160 SOUTHGATE COMMERCE BLVD, SUITE 38B, ORLANDO, FL 32806-8549
(321) 251-7877
(321) 206-8212
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11362690
CAQH
FL
01
—
322246
WELLCARE
FL
01
—
696920
UHC
FL
01
—
Y914V
BCBS
FL
Enumeration date
04/26/2006
Last updated
05/21/2015
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