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General NPI Number Information
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NPI Number | 1619115490
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Entity Type | Individual
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Provider Name | MONICA AMY KIM D.C
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Gender | Female
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 40 ALEXANDRIA BLVD STE 1020
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City | OVIEDO
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State | FL
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Zip | 32765-8910
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Country | US
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Telephone | 407-359-0047
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Fax | 407-359-0071
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Provider Business Mailing Address
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Address Line | 1451 CLAYTON DR
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City | DELTONA
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State | FL
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Zip | 32725-7457
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Country | US
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Telephone | 850-294-5280
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 9659
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License Number State | FL
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