Provider Demographics
NPI:1710025283
Name:KIM, THOMAS H (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:355 STATE ROAD 436
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-2703
Mailing Address - Country:US
Mailing Address - Phone:407-260-1566
Mailing Address - Fax:407-260-2251
Practice Address - Street 1:355 STATE ROAD 436
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-2703
Practice Address - Country:US
Practice Address - Phone:407-260-1566
Practice Address - Fax:407-260-2251
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3359152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management