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NPI Code Detail

MEDICARE: DR. ASHLEY ZAK KIMBLE O.D.

MEDICARE:  DR. ASHLEY ZAK KIMBLE  O.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
1152WP0200XPediatric OptometristOPC 4399FL
2152WV0400XVision Therapy OptometristOPC 4399FL
3152W00000XOptometrist4399FL

Other Identifiers

General Provider Information

NPI Number : 1952566721
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHLEY ZAK KIMBLE O.D.
Provider Business Mailing Address
First Line : 15508 W COLONIAL DR STE 102
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-9557
Country : US
Telephone Number : 954-849-4656
Fax Number :
Provider Business Practice Location Address
First Line : 15508 W COLONIAL DR STE 102
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-9557
Country : US
Telephone Number : 407-798-8880
Fax Number : 407-798-8810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2008
Last Update Date : 02/01/2022

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