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General NPI Number Information
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NPI Number | 1811171960
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Entity Type | Individual
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Provider Name | JIWON KIM O.M.D
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Gender | Female
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 5006 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34103-2801
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Country | US
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Telephone | 239-304-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 5006 TAMIAMI TRL N
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City | NAPLES
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State | FL
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Zip | 34103-2801
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Country | US
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Telephone | 239-961-0585
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2484
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License Number State | FL
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