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NPI Code Detail

MEDICARE: SAMANTHA MARIE KIMBLE

MEDICARE: SAMANTHA MARIE KIMBLE
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
1106S00000XBehavior Technician
2106S00000XBehavior Technician1306542543FL

General Provider Information

NPI Number : 1306542543
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA MARIE KIMBLE
Provider Business Mailing Address
First Line : 8001 BEATY GROVE DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-1602
Country : US
Telephone Number : 813-926-5454
Fax Number :
Provider Business Practice Location Address
First Line : 2180 JULIAN AVE NE
Second Line :
City : PALM BAY
State : FL
Zip : 32905-4020
Country : US
Telephone Number : 321-345-0861
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2023
Last Update Date : 04/20/2026

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Directions to “ SAMANTHA MARIE KIMBLE ” Practice Location

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