Provider Demographics
NPI:1770292989
Name:K & V COMMUNITY HEALTH SERVICES INC.
Entity type:Organization
Organization Name:K & V COMMUNITY HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-924-2124
Mailing Address - Street 1:9145 NARCOOSSEE RD
Mailing Address - Street 2:SUITE 106 PMB 109
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827
Mailing Address - Country:US
Mailing Address - Phone:407-924-2124
Mailing Address - Fax:
Practice Address - Street 1:5393 CARRARA CT
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8048
Practice Address - Country:US
Practice Address - Phone:407-924-2124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health