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General NPI Number Information
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NPI Number | 1912319047
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Entity Type | Individual
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Provider Name | ALEXANDER YOUNGJOON KIM MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 501 6TH AVE S STE C520
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4634
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Country | US
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Telephone | 727-767-8491
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Fax | 727-767-8270
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Provider Business Mailing Address
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Address Line | 601 5TH ST S STE C520
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4804
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Country | US
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Telephone | 727-767-8491
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Fax | 727-767-8270
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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 | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | ME132543
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License Number State | FL
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