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General NPI Number Information
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NPI Number | 1386820850
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Entity Type | Individual
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Provider Name | KIMBERLY H DESMOND MS
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Gender | Female
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 904 B BEACH BLVD
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250
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Country | US
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Telephone | 904-445-1622
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Fax | 904-293-1815
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Provider Business Mailing Address
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Address Line | 8550 TOUCHTON RD APT 2236
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City | JACKSONVILLE
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State | FL
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Zip | 32216-2237
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Country | US
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Telephone | 904-445-1622
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | KY-0419
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 231HA2500X
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Taxonomy Name | Assistive Technology Supplier Audiologist
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License Number | AY2158
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AY2158
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | KY-0814
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY2158
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License Number State | FL
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