Healthcare Provider Details

I. General information

NPI: 1912796319
Provider Name (Legal Business Name): KIMBERLEY ANN LAM TIN CHEUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 235
ORLANDO FL
32804-4659
US

IV. Provider business mailing address

210 VICTORIA ST APT 3808
TORONTO ONTARIO
M5B 2R3
CA

V. Phone/Fax

Practice location:
  • Phone: 407-303-5947
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTRN41940
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: