DR. SAMUEL KIM (NPI# 1629386388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629386388 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL KIM |
| Other Name | DR. SAMUEL KIM SUH |
| Credential | M.D. |
| Practice Address |
1660 Prudential Dr Suite 310 Jacksonville FL 32207-8197 |
| Mailing Address |
Po Box 45443 Salt Lake City UT 84145-0443 |
| Practice Telephone | 9043968656 |
| Practice Fax Number | 9043965931 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043764107 |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2018-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
ME120625 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 012351100 | 05 | |
| FL | RAILROAD MEDICARE | P01366451 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063059178 | Samuel Kim | Acupuncturist | 24904 34th Ave, Little Neck, NY 11363-1407 | 2019-12-08 |
| 1952841793 | Samuel Kim | Dentist | 3441 Burritt Way, La Crescenta, CA 91214 | 2017-02-27 |
| 1295107605 | Samuel Kim | Pharmacist | 1001 E Latham Ave Ste P, Hemet, CA 92543-4435 | 2015-10-24 |
| 1902224587 | Samuel M Kim | Internal Medicine | Weill Cornell Medicine Division of Cardiology, 520 East 70th Street, Starr Pavilion 4th Floor, New York, NY 10021-0010 | 2014-04-01 |
| 1174889141 | Samuel Hyojune Kim | Emergency Medicine | One Gustave L Levy Place, Box 1264, Mount Sinai Medical Center Box 1264, New York, NY 10029 | 2012-04-04 |
| 1023310687 | Samuel Sungwon Kim | Pediatrics | 150 N Robertson Blvd Ste 307, Beverly Hills, CA 90211-2145 | 2010-12-02 |
| 1245430206 | Samuel Hun Kim | General Acute Care Hospital | 1420 Crest Vista Dr, Monterey Park, CA 91754-4643 | 2007-07-18 |
| 1992916001 | Samuel I Kim | Dentist | 8811 W Sahara Ave Ste 100, Las Vegas, NV 89117-4813 | 2007-05-24 |
| 1609917285 | Samuel I Kim | Dentist | 21580 Bear Valley Rd, B2-2, Apple Valley, CA 92308-7200 | 2007-02-08 |
| 1184771172 | Samuel Suk Kim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 676 N Saint Clair St Ste 2320, Chicago, IL 60611 | 2007-01-04 |
| Street Address |
1660 PRUDENTIAL DR SUITE 310 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437132586 | Gary Thomas Gabor | Internal Medicine | 1660 Prudential Dr, Suite 310, Jacksonville, FL 32207-8197 | 2005-11-22 |
| 1497190524 | Layla Brock Mcdaniel | Physician Assistant | 1660 Prudential Dr, Suite 310, Jacksonville, FL 32207-8197 | 2013-05-02 |
| 1649595216 | Adam Walker Bagley | Internal Medicine | 1660 Prudential Dr, Suite 310, Jacksonville, FL 32207-8197 | 2010-04-07 |
| 1144424722 | Swati M Shah | Internal Medicine | 1660 Prudential Dr, Suite 310, Jacksonville, FL 32207-8197 | 2007-06-14 |
| 1215998513 | Archana Gupta Goel | Internal Medicine | 1660 Prudential Dr, Suite 310, Jacksonville, FL 32207-8197 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336606383 | Infusion Center of Jacksonville, LLC | Internal Medicine | 11512 Lake Mead Ave Ste 302-303, Jacksonville, FL 32256-9680 | 2019-02-26 |
| 1619245495 | Steven D. Mathews, M.d., P.a. | Internal Medicine | 6863 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2011-12-07 |
| 1386891604 | Aneesa Krishnamurthy | Internal Medicine | 3 Shircliff Way Ste 333, Jacksonville, FL 32204 | 2008-08-19 |
| 1639351927 | Baptist Primary Care Inc | Internal Medicine | 1660 Prudential Dr Ste 310, Jacksonville, FL 32207-8185 | 2007-11-29 |
| 1437362266 | Augusto Mayor Quilon IIi | Internal Medicine | 14810 Old Saint Augustine Rd Ste 101, Jacksonville, FL 32258-2558 | 2007-05-08 |
| 1043341795 | Annabelle K Lee | Internal Medicine | 13241 Bartram Blvd., Suite 2105, Jacksonville, FL 32258-2451 | 2007-03-07 |
| 1104987122 | Steven Dell Mathews | Internal Medicine | 6863 Belfort Oaks Place, Jacksonville, FL 32216 | 2006-12-13 |
| 1194894436 | Pamela R Neish | Internal Medicine | 1672 Dover Hill Dr, Jacksonville, FL 32225-4936 | 2006-11-08 |
| 1609962679 | Kathryn Michele Lawson | Internal Medicine | 13241 Bartram Park Blvd Unit 2105, Jacksonville, FL 32258-5224 | 2006-10-05 |
| 1437132586 | Gary Thomas Gabor | Internal Medicine | 1660 Prudential Dr, Suite 310, Jacksonville, FL 32207-8197 | 2005-11-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on DR. SAMUEL KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.