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General NPI Number Information
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NPI Number | 1609861202
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Entity Type | Individual
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Provider Name | KATHLEEN ELIZABETH MINNICK MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 11551 SOUTHERN BLVD STE 2
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-4254
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Country | US
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Telephone | 561-594-1850
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Fax | 561-594-1855
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Provider Business Mailing Address
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Address Line | PO BOX 20800
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City | BELFAST
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State | ME
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Zip | 04915-4105
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Country | US
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Telephone | 561-270-5505
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Fax | 561-437-0177
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME 78137
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License Number State | FL
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