Provider Demographics
NPI:1427559020
Name:KPW HEALTH LLC
Entity Type:Organization
Organization Name:KPW HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-657-5407
Mailing Address - Street 1:603 7TH ST S STE 540
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4734
Mailing Address - Country:US
Mailing Address - Phone:727-230-3423
Mailing Address - Fax:217-636-3056
Practice Address - Street 1:603 7TH ST S STE 540
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4734
Practice Address - Country:US
Practice Address - Phone:727-230-3423
Practice Address - Fax:217-636-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
06111OtherOXFORD HEALTH PLAN
14163OtherWELLCARE FLORIDA
62308OtherCIGNA
80214OtherCHAMPVA
FLMC010Medicaid
WELLM2OtherWELLMED/UNITED HEALTH CARE
13551OtherGHI/EMBLEM HEALTH PLAN
20133OtherOPTIMUM INSURANCE PLAN
61101OtherHUMANA, INC
64157OtherMERITAIN HEALTH
36273OtherAARP- UHC OVATIONS INSURANCE SOLUTIONS
60054OtherAETNA MEDICARE
14163OtherSTAYWELL HEALTH PLAN
28804OtherAMERIGROUP
60054OtherAETNA
62308OtherGREAT WEST PPO
68069OtherSUNSHINE MEDICAID
77003OtherPRESTIGE
BS022OtherBLUE SHIELD FLORIDA
44054OtherGEHA
95019OtherHEALTH FIRST HEALTH PLANS
39026OtherUMR
75261OtherTPA
25133OtherCOVENTRY HEALTH CARE
27094OtherSIMPLY HEALTH CARE/ CLEAR HEALTH ALLIANCE
37602OtherGOLDEN RULE INSURANCE PLAN
41212OtherFREEDOM HEALTH INSURANCE PLAN
59274OtherAVEMED HEALTH PLAN
87726OtherUNITED HEALTH CARE