Provider Demographics
NPI:1851731509
Name:FLORIDA MEDICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:FLORIDA MEDICAL SPECIALISTS, LLC
Other - Org Name:KAIZEN TOTAL WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:INITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-284-5448
Mailing Address - Street 1:PO BOX 25487
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2487
Mailing Address - Country:US
Mailing Address - Phone:941-202-5342
Mailing Address - Fax:855-253-4836
Practice Address - Street 1:4351 CORTEZ RD W
Practice Address - Street 2:SUITE 201
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210
Practice Address - Country:US
Practice Address - Phone:941-202-5342
Practice Address - Fax:855-253-4836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA MEDICAL SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-26
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAD548Medicare PIN