Provider Demographics
NPI:1831361856
Name:KEVIN INWOOD MDPA
Entity type:Organization
Organization Name:KEVIN INWOOD MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:INWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:561-745-2458
Mailing Address - Street 1:2141 ALT A1A SOUTH
Mailing Address - Street 2:STE 130
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-4063
Mailing Address - Country:US
Mailing Address - Phone:561-745-2458
Mailing Address - Fax:
Practice Address - Street 1:2141 ALT A1A SOUTH
Practice Address - Street 2:STE 130
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-4063
Practice Address - Country:US
Practice Address - Phone:561-745-2458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0052081207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL45103Medicare PIN