Healthcare Provider Details

I. General information

NPI: 1740847698
Provider Name (Legal Business Name): KYM ALOHA OPSIMA- CASINILLO FNP-BC, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KYM ALOHA DELUBIO OPSIMA BSN, RN, CCRN

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 07/20/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JFK DR STE 320
ATLANTIS FL
33462-6641
US

IV. Provider business mailing address

180 JFK DR STE 320
ATLANTIS FL
33462-6641
US

V. Phone/Fax

Practice location:
  • Phone: 561-548-4900
  • Fax: 561-434-5165
Mailing address:
  • Phone: 561-548-4900
  • Fax: 561-434-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11002522
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: