Provider Demographics
NPI:1033290291
Name:KINETIC, INC.
Entity Type:Organization
Organization Name:KINETIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:H
Authorized Official - Middle Name:
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:561-630-4404
Mailing Address - Street 1:4362 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6275
Mailing Address - Country:US
Mailing Address - Phone:561-630-4404
Mailing Address - Fax:561-630-4373
Practice Address - Street 1:4362 NORTHLAKE BLVD
Practice Address - Street 2:SUITE #202
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6275
Practice Address - Country:US
Practice Address - Phone:561-630-4404
Practice Address - Fax:561-630-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312880332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5431030002Medicare NSC