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NPI Code Detail

MEDICARE: KIMBERLY DYE

MEDICARE: KIMBERLY DYE
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
1222Q00000XDevelopmental Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851915904
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY DYE
Provider Business Mailing Address
First Line : 8418 E BAY BLVD
Second Line :
City : NAVARRE
State : FL
Zip : 32566-6306
Country : US
Telephone Number : 850-307-8811
Fax Number :
Provider Business Practice Location Address
First Line : 8418 E BAY BLVD
Second Line :
City : NAVARRE
State : FL
Zip : 32566-6306
Country : US
Telephone Number : 850-307-8811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2020
Last Update Date : 06/04/2020

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Directions to “ KIMBERLY DYE ” Practice Location

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