Provider Demographics
NPI:1598940017
Name:JOSEPH, KIMBERLY N (DC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:N
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 SUNSET DR
Mailing Address - Street 2:STE A
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4848
Mailing Address - Country:US
Mailing Address - Phone:305-666-5454
Mailing Address - Fax:305-666-5451
Practice Address - Street 1:6237 SUNSET DR
Practice Address - Street 2:STE A
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4848
Practice Address - Country:US
Practice Address - Phone:305-666-5454
Practice Address - Fax:305-666-5451
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U79565Medicare UPIN
FLHF417ZMedicare PIN