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General NPI Number Information
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NPI Number | 1326258286
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Entity Type | Individual
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Provider Name | MR. YOUNG SUN KIM
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 340 S STATE ROAD 434 STE 1034
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3861
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Country | US
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Telephone | 407-788-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 HAMPSHIRE PLACE CIR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1251
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Country | US
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Telephone | 407-292-6992
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0026250
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License Number State | FL
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