Healthcare Provider Details

I. General information

NPI: 1114846441
Provider Name (Legal Business Name): KIMBERLY HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 DUNN AVE STE 201
JACKSONVILLE FL
32218-6427
US

IV. Provider business mailing address

3450 DUNN AVE STE 201
JACKSONVILLE FL
32218-6427
US

V. Phone/Fax

Practice location:
  • Phone: 904-723-6049
  • Fax: 904-212-0748
Mailing address:
  • Phone: 904-723-6049
  • Fax: 904-212-0748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28024
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: