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NPI Code Detail

MEDICARE: KIMBERLY ANNE ESPOSITO OD

MEDICARE: KIMBERLY ANNE ESPOSITO OD
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
1152W00000XOptometrist046011129IL
2152W00000XOptometrist18004058AIN

General Provider Information

NPI Number : 1871013250
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ANNE ESPOSITO OD
Provider Business Mailing Address
First Line : PO BOX 2081
Second Line :
City : VALPARAISO
State : IN
Zip : 46384-2081
Country : US
Telephone Number : 219-879-4390
Fax Number :
Provider Business Practice Location Address
First Line : 5780 FRANKLIN ST
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-7844
Country : US
Telephone Number : 219-879-4390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2017
Last Update Date : 10/17/2023

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Directions to “ KIMBERLY ANNE ESPOSITO OD” Practice Location

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