Provider Demographics
NPI:1427009620
Name:KIM, YONG H (DC, DACNB,)
Entity Type:Individual
Prefix:DR
First Name:YONG
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:DC, DACNB,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 CRESTOVER LN STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6790
Mailing Address - Country:US
Mailing Address - Phone:813-501-8091
Mailing Address - Fax:813-803-4729
Practice Address - Street 1:2312 CRESTOVER LN STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6790
Practice Address - Country:US
Practice Address - Phone:813-501-8091
Practice Address - Fax:813-803-4729
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9101111NN0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology