Provider Demographics
NPI:1851618417
Name:STYRVOKY, KIM CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:CATHERINE
Last Name:STYRVOKY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 DON WICKHAM DR STE 127
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1978
Mailing Address - Country:US
Mailing Address - Phone:407-648-5384
Mailing Address - Fax:321-843-6975
Practice Address - Street 1:1920 DON WICKHAM DR STE 127
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1978
Practice Address - Country:US
Practice Address - Phone:407-648-5384
Practice Address - Fax:321-843-6975
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1144207RC0200X, 207RP1001X
FLME171441207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL125132200Medicaid