MEDICARE: KIMBERLY KENDALL

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	225X00000X	Occupational Therapist	OT 11562	FL

General Provider Information

NPI Number	:	1740494640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY KENDALL

Provider Business Mailing Address
First Line	:	111 BRINY AVE
Second Line	:	#604
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5612
Country	:	US
Telephone Number	:	703-298-2998
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 BRINY AVE
Second Line	:	#604
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-5612
Country	:	US
Telephone Number	:	703-298-2998
Fax Number	:

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 KENDALL ” Practice Location

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