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General NPI Number Information
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NPI Number | 1366411514
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Entity Type | Individual
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Provider Name | LANCE Y KIM DO
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2237 SW 19TH AVENUE RD STE 101
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City | OCALA
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State | FL
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Zip | 34471-7751
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Country | US
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Telephone | 352-867-9877
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Fax | 352-291-5096
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Provider Business Mailing Address
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Address Line | 2237 SW 19TH AVENUE RD
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City | OCALA
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State | FL
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Zip | 34471-7751
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Country | US
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Telephone | 352-867-9877
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Fax | 352-867-1040
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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 | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | OS7448
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | OS7448
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | OS7448
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | OS7448
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License Number State | FL
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