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General NPI Number Information
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NPI Number | 1174022321
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Entity Type | Individual
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Provider Name | KIMBERLY N SANDERS
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Gender | Female
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 2462 NW 91ST AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5113
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Country | US
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Telephone | 561-569-6152
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 LAKE WORTH RD
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City | GREENACRES
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State | FL
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Zip | 33463-4727
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Country | US
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Telephone | 561-629-5924
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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 | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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