Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME0059240 | FL |
NPI | 1144219338 |
---|---|
Provider Name | Steven C Kimmel |
First Address | Tamarac, FL 33321-2956 |
Second Address | Tamarac, FL 33321-2956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E81670 | (02) |