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General NPI Number Information
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NPI Number | 1154253938
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Entity Type | Individual
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Provider Name | KIMBERLY LYNN MOYER
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Gender | Female
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 1537 NE CEDAR ST
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City | JENSEN BEACH
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State | FL
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Zip | 34957-4808
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Country | US
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Telephone | 239-488-1583
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Fax | 239-309-0219
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Provider Business Mailing Address
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Address Line | 9420 FOUNTAIN MEDICAL CT STE 101
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4571
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Country | US
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Telephone | 239-488-1583
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Fax | 239-309-0219
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT12689
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License Number State | FL
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