MIND, BODY & MODERN MEDICINE, LLC
NPI 1912302787
Physician Assistant - Medical in Land O'lakes, FL

Active since October 23, 2014
19401 SHUMARD OAK DR, CLARITY MEDSPA, LAND O'LAKES, FL 34638(727) 264-1364 Get Directions Write a Review

NPPES record last updated: October 23, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Physician Assistant
  • Medical

About MIND, BODY & MODERN MEDICINE, LLC

This page provides the complete NPI Profile along with additional information for Mind, Body & Modern Medicine, Llc, a primary care provider established in Land O'lakes, Florida operating as a Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1912302787 assigned on October 2014. The practitioner's primary taxonomy code is 363AM0700X with license number 9101970 (FL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Ms. Faith I Bevan Pa-c (Manager)

NPI
1912302787 Verify this NPI
Provider Name
MIND, BODY & MODERN MEDICINE, LLC
Entity Type
Organization
Location Address
19401 SHUMARD OAK DR CLARITY MEDSPA LAND O'LAKES, FL 34638
Location Phone
(727) 264-1364
Mailing Address
8341 CAROLYN DR PORT RICHEY, FL 34668
Mailing Phone
(727) 264-1364
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-23-2014
Last Update Date
10-23-2014
Code Navigator

A primary care provider (PCP) like Mind, Body & Modern Medicine, Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
9101970
License State
FL

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. FAITH I BEVAN PA-C

Authorized Official Title
MANAGER
Authorized Official Phone
(727) 992-3440

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Clinic/Center (Sleep Disorder Diagnostic)
19401 SHUMARD OAK DR
LAND O LAKES, FL 34638
Clinic/Center (Sleep Disorder Diagnostic)
19401 SHUMARD OAK DR
LAND O LAKES, FL 34638

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912302787, enumerated as an "organization" on October 23, 2014.

The provider is located at 19401 SHUMARD OAK DR CLARITY MEDSPA LAND O'LAKES, FL 34638 and the phone number is (727) 264-1364.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.