KIN MED PA NPI 1861994204

NPI Information

NPI: 1861994204
Provider Name: KIN MED, PA
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
19910 S TAMIAMI TRAIL STE C
ESTERO, FL
ZIP 33928
Phone: (239) 948-1222
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KIN MED, PA is a general practice in Estero, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee KIN MED, PA NPI is 1861994204. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

19910 S TAMIAMI TRAIL STE C
ESTERO, FL
ZIP 33928
Phone: (239) 948-1222
Fax: (239) 948-1221

The provider's authorized official is Lyette Rose Boucher .
The authorized official title is President and has the following contact phone number (239) 948-1222.

The enumeration date for this NPI number is 3/1/2018 and was last updated on 3/1/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	208D00000X	General Practice	CH11313	FLORIDA	Yes
2	208D00000X	General Practice	CH11148		No
3	363A00000X	Physician Assistant	P.A.9104809	FLORIDA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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