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General NPI Number Information
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NPI Number | 1528318045
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Entity Type | Organization
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Legal Business Name | THOMAS H. KIM O.D.,P.A.
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 355 SEMORAN BLVD
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City | FERN PARK
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State | FL
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Zip | 32730-2703
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Country | US
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Telephone | 407-260-1566
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Fax | 407-260-2251
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Provider Business Mailing Address
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Address Line | 355 SEMORAN BLVD
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City | FERN PARK
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State | FL
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Zip | 32730-2703
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Country | US
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Telephone | 407-260-1566
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Fax | 407-260-2251
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS H KIM
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Credential |
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Telephone | 407-765-0992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC3359
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License Number State | FL
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