Provider Demographics
NPI:1164569851
Name:LAMKE, KIMBERLY O (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:O
Last Name:LAMKE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16640 VALLELY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1152
Mailing Address - Country:US
Mailing Address - Phone:813-422-9110
Mailing Address - Fax:
Practice Address - Street 1:16640 VALLELY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1152
Practice Address - Country:US
Practice Address - Phone:813-422-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9401225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics