Organization
KBS MEDICAL PA
Active
Other names
Innerwell
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KENNEDY (COO)
(212) 620-3053
Entity
Organization
Contact information
Practice address
3350 SW 148TH AVE STE 110, MIRAMAR, FL 33027-3237
(847) 420-5269
Mailing address
169 MADISON AVE STE 15824, NEW YORK, NY 10016-5101
(844) 440-2410
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
07/25/2022
Last updated
04/16/2026
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