Healthcare Provider Details

I. General information

NPI: 1760147367
Provider Name (Legal Business Name): KIMBERLY ANN HUE-LAING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 NW 13TH ST SUITE 400 4TH FLOR
BOCA RATON FL
33486-2342
US

IV. Provider business mailing address

880 NW 13TH STREET SUITE 400 4TH FLOOR
BOCA RATON FL
33486-2342
US

V. Phone/Fax

Practice location:
  • Phone: 561-297-4814
  • Fax: 561-297-4828
Mailing address:
  • Phone: 561-297-4814
  • Fax: 561-297-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11016490
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: