Divine Aging, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DIVINE AGING, LLC

Practice address

2325 Ulmerton Rd
Suite 19
Clearwater, FL 33762-2282

Phone

(727) 271-1984

Fax

(727) 210-3036

NPI assigned

Oct 23, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Parvinder S Kainth

Title

Owner

Phone

(727) 271-1984

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1699147116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 ULMERTON RD",
            "address_2": "SUITE 19",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337622282",
            "telephone_number": "727-271-1984",
            "fax_number": "727-210-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 ULMERTON RD",
            "address_2": "SUITE 19",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337622282",
            "telephone_number": "727-271-1984",
            "fax_number": "727-210-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE AGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "KAINTH",
        "authorized_official_first_name": "PARVINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-271-1984",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.