Provider Demographics
NPI:1073234704
Name:HOUSE CALL DOCTORS CFL
Entity Type:Organization
Organization Name:HOUSE CALL DOCTORS CFL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DR. BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMEMIA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:360-863-6696
Mailing Address - Street 1:10224 AIRPORT WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8203
Mailing Address - Country:US
Mailing Address - Phone:360-863-6696
Mailing Address - Fax:360-863-2145
Practice Address - Street 1:7901 4TH ST N STE 300
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4399
Practice Address - Country:US
Practice Address - Phone:360-863-6696
Practice Address - Fax:360-863-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)