Healthcare Provider Details

I. General information

NPI: 1902500457
Provider Name (Legal Business Name): KIMBERLY ANNE SLEIMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 W 79TH ST
HIALEAH FL
33014-3445
US

IV. Provider business mailing address

1229 W 79TH ST
HIALEAH FL
33014-3445
US

V. Phone/Fax

Practice location:
  • Phone: 786-587-7923
  • Fax:
Mailing address:
  • Phone: 786-587-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-226603
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: