Provider Demographics
NPI:1851475875
Name:KIMBO, FLORENCE V (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:V
Last Name:KIMBO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:18660 BAGLEY RD BLDG II
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3483
Mailing Address - Country:US
Mailing Address - Phone:440-234-8746
Mailing Address - Fax:440-234-8748
Practice Address - Street 1:18660 BAGLEY RD
Practice Address - Street 2:SUITE 204
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3483
Practice Address - Country:US
Practice Address - Phone:440-234-8746
Practice Address - Fax:440-234-8748
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH350857382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150223Medicaid
H076630Medicare PIN
OH0150223Medicaid