Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | ME00066157 | FL |
NPI | 1164475679 |
---|---|
Provider Name | Kimberly Ann Thompson |
First Address | South Miami, FL 33143-4806 |
Second Address | South Miami, FL 33143-4806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 17/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F12042 | (02) | FL |