MEDICARE: JULIE MIN JEONG KIM A.P.

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	171100000X	Acupuncturist	AP3769	FL

General Provider Information

NPI Number	:	1427507664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MIN JEONG KIM A.P.

Provider Business Mailing Address
First Line	:	455 NE 25TH ST APT 808
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33137-4757
Country	:	US
Telephone Number	:	305-803-1050
Fax Number	:

Provider Business Practice Location Address
First Line	:	9999 NE 2ND AVE STE 313
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2346
Country	:	US
Telephone Number	:	305-771-2115
Fax Number	:

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

Provider Enumeration Date	:	09/29/2016
Last Update Date	:	11/14/2022

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