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General NPI Number Information
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NPI Number | 1922179746
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Entity Type | Organization
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Legal Business Name | JOEL I KIMMEL PHD PA
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 5551 N UNIVERSITY DR SUITE 102
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4651
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Country | US
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Telephone | 954-755-2885
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Fax | 954-344-6007
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Provider Business Mailing Address
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Address Line | 5551 N UNIVERSITY DR SUITE 102
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4651
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Country | US
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Telephone | 954-755-2885
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Fax | 954-344-6007
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JOEL I KIMMEL
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Credential | PH.D.
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Telephone | 954-755-2885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY2344
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License Number State | FL
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