Provider Demographics
NPI:1821489642
Name:KIM, ESTHER E (MS ATC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:E
Last Name:KIM
Suffix:
Gender:F
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1532 OAKFIELD DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-0829
Mailing Address - Country:US
Mailing Address - Phone:813-381-3852
Mailing Address - Fax:813-381-3873
Practice Address - Street 1:1901 DR MARTIN LUTHER KING JR ST N
Practice Address - Street 2:SUITE B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4272
Practice Address - Country:US
Practice Address - Phone:727-898-3852
Practice Address - Fax:727-381-3873
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAL33522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer