Provider Demographics
NPI:1366646804
Name:HULL, KIMBERLY JENNIFER (DO)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JENNIFER
Last Name:HULL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:JENNIFER
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 N UNIVERSITY DR
Mailing Address - Street 2:SUITE K
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5055
Mailing Address - Country:US
Mailing Address - Phone:954-752-2630
Mailing Address - Fax:954-755-1865
Practice Address - Street 1:3000 N UNIVERSITY DR
Practice Address - Street 2:SUITE K
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5055
Practice Address - Country:US
Practice Address - Phone:954-752-2630
Practice Address - Fax:954-755-1865
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11414207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology