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General NPI Number Information
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NPI Number | 1487276796
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Entity Type | Individual
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Provider Name | KIMBERLY ZUHAYL LOPEZ CLEMENTE
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Gender | Female
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 1410 SPARTA ST STE 6
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City | MCMINNVILLE
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State | TN
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Zip | 37110-1376
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Country | US
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Telephone | 931-474-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 10300 NW 10TH AVE
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City | MIAMI
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State | FL
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Zip | 33150-1015
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Country | US
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Telephone | 340-332-5025
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LE173333
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 75143
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License Number State | TN
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