Provider Demographics
NPI:1326064791
Name:KAYE, KIMBERLY A (MD)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:A
Last Name:KAYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 S.W. 91ST DRIVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8140
Mailing Address - Country:US
Mailing Address - Phone:352-367-9602
Mailing Address - Fax:352-378-5927
Practice Address - Street 1:4750 S.W. 91ST DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8140
Practice Address - Country:US
Practice Address - Phone:352-367-9602
Practice Address - Fax:352-378-5927
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071609207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68894OtherBCBS
68894YMedicare ID - Type Unspecified
FL68894OtherBCBS
FLK0934Medicare PIN
FLG69919Medicare UPIN