Healthcare Provider Details

I. General information

NPI: 1851475875
Provider Name (Legal Business Name): FLORENCE V KIMBO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18660 BAGLEY RD STE 404A
MIDDLEBURG HEIGHTS OH
44130-3482
US

IV. Provider business mailing address

18660 BAGLEY RD STE 404A
MIDDLEBURG HEIGHTS OH
44130-3482
US

V. Phone/Fax

Practice location:
  • Phone: 440-234-8746
  • Fax: 440-234-8748
Mailing address:
  • Phone: 440-234-8746
  • Fax: 440-234-8748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number35-085738
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35085738
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: