Provider Demographics
NPI:1427559020
Name:KPW HEALTH LLC
Entity type:Organization
Organization Name:KPW HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-657-5407
Mailing Address - Street 1:900 CARILLON PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1115
Mailing Address - Country:US
Mailing Address - Phone:727-230-3423
Mailing Address - Fax:217-636-3056
Practice Address - Street 1:900 CARILLON PKWY STE 301
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1115
Practice Address - Country:US
Practice Address - Phone:727-230-3423
Practice Address - Fax:217-636-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
61101OtherHUMANA, INC
FLMC010Medicaid
14163OtherWELLCARE FLORIDA
39026OtherUMR
59274OtherAVEMED HEALTH PLAN
62308OtherCIGNA
64157OtherMERITAIN HEALTH
13551OtherGHI/EMBLEM HEALTH PLAN
28804OtherAMERIGROUP
68069OtherSUNSHINE MEDICAID
WELLM2OtherWELLMED/UNITED HEALTH CARE
25133OtherCOVENTRY HEALTH CARE
36273OtherAARP- UHC OVATIONS INSURANCE SOLUTIONS
37602OtherGOLDEN RULE INSURANCE PLAN
80214OtherCHAMPVA
BS022OtherBLUE SHIELD FLORIDA
20133OtherOPTIMUM INSURANCE PLAN
41212OtherFREEDOM HEALTH INSURANCE PLAN
44054OtherGEHA
75261OtherTPA
87726OtherUNITED HEALTH CARE
06111OtherOXFORD HEALTH PLAN
27094OtherSIMPLY HEALTH CARE/ CLEAR HEALTH ALLIANCE
77003OtherPRESTIGE
95019OtherHEALTH FIRST HEALTH PLANS
14163OtherSTAYWELL HEALTH PLAN
60054OtherAETNA
60054OtherAETNA MEDICARE
62308OtherGREAT WEST PPO