MEDICARE: KIMBERLY LEE ADAMS

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		FL

General Provider Information

NPI Number	:	1952250615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY LEE ADAMS

Provider Business Mailing Address
First Line	:	11241 W ATLANTIC BLVD # 204F
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5145
Country	:	US
Telephone Number	:	561-945-4996
Fax Number	:

Provider Business Practice Location Address
First Line	:	11241 W ATLANTIC BLVD # 204F
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5145
Country	:	US
Telephone Number	:	561-945-4996
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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