Provider Demographics
NPI:1285005371
Name:XOURAFAS, KIM
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:XOURAFAS
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 1:1024 TAMARAC DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34690-6543
Mailing Address - Country:US
Mailing Address - Phone:602-909-6179
Mailing Address - Fax:
Practice Address - Street 1:1024 TAMARAC DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-6543
Practice Address - Country:US
Practice Address - Phone:602-909-6179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN080037163W00000X
FLRN9393063163W00000X
CARN807764163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse