Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME134078 | FL |
Y | 111NI0900X | Internist | ME134078 | FL |
N | 207V00000X | Obstetrician & Gynecologist | L226170 | MI |
NPI | 1003228628 |
---|---|
Provider Name | Ms. Kimberly Michelle Biichle |
First Address | Lady Lake, FL 32159-8957 |
Second Address | Lady Lake, FL 32159-8957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2014 |
Last Update Date | 28/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003228628 | (05) | MI |