Provider Demographics
NPI:1790974392
Name:THOMA, KIMIKO KELLY (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMIKO
Middle Name:KELLY
Last Name:THOMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1890 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8963
Mailing Address - Country:US
Mailing Address - Phone:954-227-2700
Mailing Address - Fax:954-227-2704
Practice Address - Street 1:1890 N UNIVERSITY DR
Practice Address - Street 2:SUITE 215
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8963
Practice Address - Country:US
Practice Address - Phone:954-227-2700
Practice Address - Fax:954-227-2704
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 998122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry