Provider Demographics
NPI:1174135727
Name:K2D3 ENTERPRISE LLC
Entity type:Organization
Organization Name:K2D3 ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE DUPREE
Authorized Official - Middle Name:AP
Authorized Official - Last Name:DAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:172-791-4747
Mailing Address - Street 1:5999 CENTRAL AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8535
Mailing Address - Country:US
Mailing Address - Phone:277-419-7472
Mailing Address - Fax:727-499-6121
Practice Address - Street 1:5999 CENTRAL AVE STE 403
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8535
Practice Address - Country:US
Practice Address - Phone:727-419-7472
Practice Address - Fax:727-499-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care