Healthcare Provider Details

I. General information

NPI: 1114521432
Provider Name (Legal Business Name): KIMBERLY LLUBERES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2020
Last Update Date: 11/27/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103530 OVERSEAS HWY UNIT 1773
KEY LARGO FL
33037-2839
US

IV. Provider business mailing address

19021 SW 97TH AVE
CUTLER BAY FL
33157-7831
US

V. Phone/Fax

Practice location:
  • Phone: 786-333-2975
  • Fax:
Mailing address:
  • Phone: 305-910-8056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: