Provider Demographics
NPI:1093081580
Name:KIMSEY MARKOVICH, REBECA ANN (MD)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:ANN
Last Name:KIMSEY MARKOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECA
Other - Middle Name:ANN
Other - Last Name:KIMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:975 BAPTIST WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7600
Mailing Address - Country:US
Mailing Address - Phone:305-245-4549
Mailing Address - Fax:305-245-4590
Practice Address - Street 1:975 BAPTIST WAY STE 103
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:305-245-4549
Practice Address - Fax:305-245-4590
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123947208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics