Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mind, Body & Modern Medicine, LLC

Organization Medical Physician Assistant · NPI 1912302787

Mind, Body & Modern Medicine, LLC is a Medical Physician Assistant in Land O Lakes, Florida. Licensed in Florida. Registered with an NPI since 2014.

Licensed in
FL
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

19401 Shumard Oak Dr Clarity Medspa
Land O Lakes, FL 34638
Phone: (727) 264-1364
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 9101970 (FL)

Record details

NPI number1912302787
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Faith Bevan — Manager · (727) 992-3440
NPI enumeratedOctober 23, 2014
Last updated in NPPESOctober 23, 2014
Mailing address8341 Carolyn Dr, Port Richey, FL 34668-6210

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