Provider Demographics
NPI:1679925739
Name:MILLER, KIMBERLY DAWN (PHARM D)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DAWN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:DAWN
Other - Last Name:ROBINETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13583 MANCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109
Mailing Address - Country:US
Mailing Address - Phone:239-734-4060
Mailing Address - Fax:423-246-8240
Practice Address - Street 1:13583 MANCHESTER WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:239-734-4060
Practice Address - Fax:423-246-8240
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$OtherSOCIAL SECURITY