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General NPI Number Information
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NPI Number | 1457788960
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Entity Type | Organization
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Legal Business Name | FLORENCE KIMBO M.D., LLC
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Dates
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Enumeration Date | 09/28/2013
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 18660 BAGLEY RD BLDG 1 SUITE 404
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City | CLEVELAND
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State | OH
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Zip | 44130-3483
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Country | US
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Telephone | 440-234-8746
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Fax |
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Provider Business Mailing Address
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Address Line | 18660 BAGLEY RD BLDG 1 SUITE 404
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City | CLEVELAND
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State | OH
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Zip | 44130-3483
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Country | US
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Telephone | 440-234-8746
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FLORENCE V KIMBO
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Credential |
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Telephone | 440-234-8746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1000379
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 35085738
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 35087776
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | COA12811
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35094183
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License Number State | OH
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