Provider Demographics
NPI:1003909268
Name:MARX, KIM A (RRT,RPFT)
Entity Type:Individual
Prefix:MR
First Name:KIM
Middle Name:A
Last Name:MARX
Suffix:
Gender:M
Credentials:RRT,RPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 LONGFELLOW RD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2362
Mailing Address - Country:US
Mailing Address - Phone:863-326-5933
Mailing Address - Fax:863-293-3221
Practice Address - Street 1:346 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3046
Practice Address - Country:US
Practice Address - Phone:863-291-8644
Practice Address - Fax:863-293-3221
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT 0552227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered