Kanokrat Clinic LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

KANOKRAT CLINIC LLC

Practice address

211 Caroline St Ofc
Cape Canaveral, FL 32920-2763

Phone

(321) 613-2970

NPI assigned

Sep 1, 2021

Organization subpart

No

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

Authorized official

Name

Teeraporn Wells

Title

Aprn/Owner

Phone

(321) 848-5393

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kanokrat Clinic Other name

Locations

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639180800000",
    "number": "1972271245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CAROLINE ST OFC",
            "city": "CAPE CANAVERAL",
            "state": "FL",
            "postal_code": "329202763",
            "telephone_number": "321-417-1557",
            "fax_number": "321-204-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CAROLINE ST OFC",
            "city": "CAPE CANAVERAL",
            "state": "FL",
            "postal_code": "329202763",
            "telephone_number": "321-613-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANOKRAT CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-12-11",
        "certification_date": "2021-12-11",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TEERAPORN",
        "authorized_official_title_or_position": "APRN/OWNER",
        "authorized_official_telephone_number": "321-848-5393"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kanokrat Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Health Service Clinic/Center in Cape Canaveral, FL
• Providers in Cape Canaveral, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2021; 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.