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General NPI Number Information
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NPI Number | 1073970943
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Entity Type | Individual
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Provider Name | KIMBERLY CAMILLE CARTER MAHAMID KIMBERLY CARTER PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/24/2016
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 410 CELEBRATION PL STE 401A
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City | CELEBRATION
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State | FL
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Zip | 34747-5436
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Country | US
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Telephone | 407-303-3820
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Fax |
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Provider Business Mailing Address
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Address Line | 265 E ROLLINS ST STE 5000
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City | ORLANDO
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State | FL
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Zip | 32804-5525
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Country | US
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Telephone | 407-821-3540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9109235
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA-9109235
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License Number State | FL
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