MEDICARE: KIMBERLY JOHNSEN BACHMAN P.A.

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	363A00000X	Physician Assistant	PA 3013	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	:	1720213549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY JOHNSEN BACHMAN P.A.

Provider Business Mailing Address
First Line	:	11020 RCA CENTER DRIVE
Second Line	:	SUITE 2010
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410
Country	:	US
Telephone Number	:	561-881-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	11020 RCA CENTER DR
Second Line	:	SUITE 2010
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4277
Country	:	US
Telephone Number	:	561-881-8800
Fax Number	:

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

Provider Enumeration Date	:	05/22/2009
Last Update Date	:	05/22/2009

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