Provider Demographics
NPI:1972826113
Name:HASKINS, KIM STEPNEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:STEPNEN
Last Name:HASKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:HASKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 292527
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-2527
Mailing Address - Country:US
Mailing Address - Phone:954-326-8488
Mailing Address - Fax:
Practice Address - Street 1:10609 INDIAN TRL
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-5513
Practice Address - Country:US
Practice Address - Phone:954-326-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME444842080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine