DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1003045097

NPI Code Detail

MEDICARE: DR. ELIJAH KIM M.D.

MEDICARE: DR. ELIJAH KIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME152670	FL
2	208600000X	Surgery Physician	52389	TN
3	208600000X	Surgery Physician	036-143764	IL
4	2086S0102X	Surgical Critical Care Physician	036-143764	IL
5	2086S0102X	Surgical Critical Care Physician	52389	TN
6	2086S0127X	Trauma Surgery Physician	87843	GA
7	2086S0127X	Trauma Surgery Physician	036-143764	IL
8	2086S0102X	Surgical Critical Care Physician	ME152670	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003045097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIJAH KIM M.D.

Provider Business Mailing Address
First Line	:	1700 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-3555
Country	:	US
Telephone Number	:	941-917-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-3555
Country	:	US
Telephone Number	:	941-917-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	08/19/2025

Similar Medicare Providers

1356205686 — MRS. EMILY BRENNAN MORGAN RN
Practice Location Address:

1700 S TAMIAMI TRL
SARASOTA, FL
34239-3555

Practice Phone: 941-917-9000
Practice Fax:

1295359933 — DR. BOBBY RAJESH MALIK DO
Practice Location Address:

1700 S TAMIAMI TRL
SARASOTA, FL
34239-3555

Practice Phone: 941-917-2041
Practice Fax:

1861462988 — DARLENE RENNER ARNP
Practice Location Address:

1700 S TAMIAMI TRL
SARASOTA, FL
34239-3555

Practice Phone: 941-917-4800
Practice Fax:

1528014545 — DR. DEAN THEOPHILOPOULOS M.D.
Practice Location Address:

1700 S TAMIAMI TRL
SARASOTA, FL
34239-3555

Practice Phone: 941-917-5525
Practice Fax: 941-917-1689

1336340090 — TAREN LEIGH OHMAN M.D.
Practice Location Address:

1700 S TAMIAMI TRL
SARASOTA, FL
34239-3555

Practice Phone: 941-917-7799
Practice Fax:

1528390135 — PHILLIP V OLIVER CRNA
Practice Location Address:

1700 S TAMIAMI TRL
SARASOTA, FL
34239-3555

Practice Phone: 941-917-9000
Practice Fax:

Directions to “ DR. ELIJAH KIM M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.