Provider Demographics
NPI:1992967160
Name:MERKEL, KIMBERLY LAUREL (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LAUREL
Last Name:MERKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5571 SW 64TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9608
Mailing Address - Country:US
Mailing Address - Phone:352-337-4900
Mailing Address - Fax:352-337-4990
Practice Address - Street 1:5571 SW 64TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9608
Practice Address - Country:US
Practice Address - Phone:352-337-4900
Practice Address - Fax:352-337-4990
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113514207N00000X, 207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGL642ZMedicare PIN