Provider Demographics
NPI:1932176757
Name:HORTON-BENDER, KIMBERLY J (DC, DACBN, CCN)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:J
Last Name:HORTON-BENDER
Suffix:
Gender:F
Credentials:DC, DACBN, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 BARBARA CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR
Mailing Address - State:FL
Mailing Address - Zip Code:33756-1042
Mailing Address - Country:US
Mailing Address - Phone:727-559-8036
Mailing Address - Fax:
Practice Address - Street 1:321 INDIAN ROCKS RD N
Practice Address - Street 2:SUITE C
Practice Address - City:BELLEAIR BLUFFS
Practice Address - State:FL
Practice Address - Zip Code:33770-2000
Practice Address - Country:US
Practice Address - Phone:727-559-7881
Practice Address - Fax:727-559-7981
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040335OtherWORKMANS COMP
FL3807614-00Medicaid
FL3807614-00Medicaid
FL040335OtherWORKMANS COMP