MEDICARE: KIMBERLY DANA HALL APRN

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	207Q00000X	Family Medicine Physician	11011062	FL

General Provider Information

NPI Number	:	1861320095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DANA HALL APRN

Provider Business Mailing Address
First Line	:	12719 SW 27TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-3822
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12719 SW 27TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-3822
Country	:	US
Telephone Number	:	786-246-5299
Fax Number	:

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

Provider Enumeration Date	:	05/09/2026
Last Update Date	:	05/09/2026

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