Provider Demographics
NPI:1497733976
Name:GOLDMINTZ, KIM HOPE (DO)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:HOPE
Last Name:GOLDMINTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3156 INVERNESS
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1816
Mailing Address - Country:US
Mailing Address - Phone:954-707-1955
Mailing Address - Fax:
Practice Address - Street 1:3156 INVERNESS
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-1816
Practice Address - Country:US
Practice Address - Phone:954-707-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7760207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH30880Medicare UPIN
35865Medicare ID - Type Unspecified