Healthcare Provider Details

I. General information

NPI: 1417293093
Provider Name (Legal Business Name): KIM VAN BEUREN DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2012
Last Update Date: 12/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 SILVER OAKS CIR #12201
NAPLES FL
34119-4663
US

IV. Provider business mailing address

61 SILVER OAKS CIR #12201
NAPLES FL
34119-4663
US

V. Phone/Fax

Practice location:
  • Phone: 305-731-7799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number7357
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: