Provider Demographics
NPI:1225890031
Name:ASHRAFT, KIMBERLY L
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:ASHRAFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 PHILLIPS ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2315
Mailing Address - Country:US
Mailing Address - Phone:859-552-0338
Mailing Address - Fax:
Practice Address - Street 1:1590 TROPIC PARK DR STE 1590
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-6323
Practice Address - Country:US
Practice Address - Phone:859-552-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management