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General NPI Number Information
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NPI Number | 1538706387
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Entity Type | Individual
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Provider Name | KIMBERLY DOS SANTOS
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Gender | Female
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 80 RIVERVIEW BND S UNIT 811
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City | PALM COAST
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State | FL
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Zip | 32137-6584
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Country | US
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Telephone | 386-222-3224
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Fax | 386-382-3984
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Provider Business Mailing Address
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Address Line | 80 RIVERVIEW BND S UNIT 811
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City | PALM COAST
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State | FL
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Zip | 32137-6584
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Country | US
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Telephone | 386-315-9455
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT35245
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License Number State | FL
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