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NPI Code Detail

MEDICARE: KIMBERLY JO LOHSE

MEDICARE: KIMBERLY JO LOHSE
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
1235Z00000XSpeech-Language PathologistSA 4993FL

General Provider Information

NPI Number : 1427262773
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY JO LOHSE
Provider Business Mailing Address
First Line : 9652 SW GRANADA CT
Second Line :
City : PALM CITY
State : FL
Zip : 34990-5455
Country : US
Telephone Number : 772-597-4298
Fax Number : 772-597-4298
Provider Business Practice Location Address
First Line : 9652 SW GRANADA CT
Second Line :
City : PALM CITY
State : FL
Zip : 34990-5455
Country : US
Telephone Number : 772-597-4298
Fax Number : 772-597-4298
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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Directions to “ KIMBERLY JO LOHSE ” Practice Location

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