Healthcare Provider Details

I. General information

NPI: 1528133295
Provider Name (Legal Business Name): ROSEMARIE L KIMELMAN R.D., L.D., C.D.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12990 SW 56TH ST
SOUTHWEST RANCHES FL
33330-3230
US

IV. Provider business mailing address

12990 SW 56TH ST
SOUTHWEST RANCHES FL
33330-3230
US

V. Phone/Fax

Practice location:
  • Phone: 954-434-0211
  • Fax: 954-680-8639
Mailing address:
  • Phone: 954-434-0211
  • Fax: 954-680-8639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND20
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: