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General NPI Number Information
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NPI Number | 1346786621
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Entity Type | Organization
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Legal Business Name | KIMKESI MORGAN
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Dates
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Enumeration Date | 01/11/2017
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 14365 QUEENSIDE ST
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City | ORLANDO
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State | FL
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Zip | 32824
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Country | US
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Telephone | 407-608-9238
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Fax |
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Provider Business Mailing Address
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Address Line | 14365 QUEENSIDE ST
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City | ORLANDO
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State | FL
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Zip | 32824-4261
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Country | US
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Telephone | 407-608-9238
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. KIMKESIA MORGAN
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Credential |
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Telephone | 407-608-9238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | OT10479
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License Number State | FL
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