Provider Demographics
NPI:1326550245
Name:CONTRERAS, KIMBERLYN (DC)
Entity Type:Individual
Prefix:
First Name:KIMBERLYN
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 E OSCEOLA PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1621
Mailing Address - Country:US
Mailing Address - Phone:407-807-0101
Mailing Address - Fax:
Practice Address - Street 1:1210 E OSCEOLA PKWY STE 302
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1621
Practice Address - Country:US
Practice Address - Phone:407-807-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor