Organization
DIVINE AGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PARVINDER S KAINTH (OWNER)
(727) 271-1984
Entity
Organization
Contact information
Practice address
2325 ULMERTON RD, SUITE 19, CLEARWATER, FL 33762-2282
(727) 271-1984
(727) 210-3036
Mailing address
2325 ULMERTON RD, SUITE 19, CLEARWATER, FL 33762-2282
(727) 271-1984
(727) 210-3036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
FL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/23/2015
Last updated
10/07/2016
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