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General NPI Number Information
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NPI Number | 1265923841
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Entity Type | Individual
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Provider Name | ROBERT KIM
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Gender | Male
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Dates
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Enumeration Date | 05/20/2018
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Last Update Date | 03/09/2025
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Provider Practice Location Address
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Address Line | 4109 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-5530
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Country | US
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Telephone | 954-563-2707
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Fax |
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Provider Business Mailing Address
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Address Line | 4109 N FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-5530
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Country | US
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Telephone | 954-563-2707
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | OS18450
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS18450
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License Number State | FL
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