Healthcare Provider Details

I. General information

NPI: 1902921067
Provider Name (Legal Business Name): KIMMERLE CHRISHINA COHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11621 KEW GARDENS AVE STE 101A
PALM BEACH GARDENS FL
33410-2853
US

IV. Provider business mailing address

1450 CENTREPARK BLVD STE 165
WEST PALM BEACH FL
33401-7432
US

V. Phone/Fax

Practice location:
  • Phone: 561-253-3980
  • Fax: 561-253-3985
Mailing address:
  • Phone: 561-253-3980
  • Fax: 561-253-3985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME1133344
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: