Healthcare Provider Details

I. General information

NPI: 1457596488
Provider Name (Legal Business Name): KIMBERLY ANN KAISER CMA; MT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MACARTHUR CSWY
MIAMI BEACH FL
33139-5101
US

IV. Provider business mailing address

100 MACARTHUR CSWY
MIAMI BEACH FL
33139-5101
US

V. Phone/Fax

Practice location:
  • Phone: 305-535-4350
  • Fax: 305-535-4413
Mailing address:
  • Phone: 305-535-4350
  • Fax: 305-535-4413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number0513
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: