Provider Demographics
NPI:1386646818
Name:OMLER, KIMBERLE R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLE
Middle Name:R
Last Name:OMLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3284
Mailing Address - Country:US
Mailing Address - Phone:772-778-5623
Mailing Address - Fax:
Practice Address - Street 1:1576 29TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3284
Practice Address - Country:US
Practice Address - Phone:772-778-5623
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38680183500000X
OH03-2-09808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist