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NPI Code Detail

MEDICARE: KIMBERLY B FEDER O.D.

MEDICARE: KIMBERLY B FEDER O.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
1152W00000XOptometristOPC4043FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073551735
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY B FEDER O.D.
Provider Business Mailing Address
First Line : 9617 GULF RESEARCH LN
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4560
Country : US
Telephone Number : 239-418-0999
Fax Number : 239-418-0091
Provider Business Practice Location Address
First Line : 9617 GULF RESEARCH LN
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4560
Country : US
Telephone Number : 239-418-0999
Fax Number : 239-418-0091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 12/13/2024

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Directions to “ KIMBERLY B FEDER O.D.” Practice Location

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