MEDICARE: DR. KIMBERLY SUE LAMB AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AUD004031	GA
2	231H00000X	Audiologist	1601000650	MI
3	231H00000X	Audiologist	AY2121	FL

General Provider Information

NPI Number	:	1073955423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY SUE LAMB AU.D.

Provider Business Mailing Address
First Line	:	2755 S BAY ST STE F
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32726-6587
Country	:	US
Telephone Number	:	352-483-4327
Fax Number	:

Provider Business Practice Location Address
First Line	:	2755 S BAY ST STE F
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32726-6587
Country	:	US
Telephone Number	:	352-483-4327
Fax Number	:	352-483-4328

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2013
Last Update Date	:	06/25/2022

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