Provider Demographics
NPI:1144219338
Name:KIMMEL, STEVEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:KIMMEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7431 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2956
Mailing Address - Country:US
Mailing Address - Phone:954-724-5560
Mailing Address - Fax:954-724-5563
Practice Address - Street 1:7431 N UNIVERSITY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2956
Practice Address - Country:US
Practice Address - Phone:954-724-5560
Practice Address - Fax:954-724-5563
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059240207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11949Medicare ID - Type Unspecified
E81670Medicare UPIN