KIN MED, PA (NPI# 1861994204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861994204 |
| Entity Type | Organization |
| Organization Name | KIN MED, PA |
| Practice Address |
19910 S Tamiami Trail Ste C Estero FL 33928 |
| Mailing Address |
19910 S. Tamiami Trail Ste C Estero FL 33928 |
| Practice Telephone | 2399481222 |
| Practice Fax Number | 2399481221 |
| Mailing Telephone | 2399481222 |
| Mailing Fax Number | 2399481221 |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |
| Authorized Official Name | DR. LYETTE ROSE BOUCHER (PRESIDENT) |
| Authorized Official Telephone | 2399481222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | CH11148 | Allopathic & Osteopathic Physicians | |
| N | 363A00000X | Physician Assistant | P.A.9104809 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 208D00000X | General Practice | CH11313 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
19910 S TAMIAMI TRAIL STE C |
| City | ESTERO |
| State | FL |
| Zip Code | 33928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578055588 | Jeremiah S Mossman | Nurse Anesthetist, Certified Registered | 21586 Belvedere Ln, Estero, FL 33928 | 2018-06-05 |
| 1376030361 | Trish Daino Lisw LLC | Social Worker | 9180 Estero Park Commons, Ste 2, Suite 2, Estero, FL 33928 | 2018-04-16 |
| 1073031225 | Dieu Huyen Thi Le | Pharmacist | 20311 Grande Oak Blvd, Estero, FL 33928 | 2017-09-07 |
| 1295284008 | National Vision, Inc. | Technician/Technologist | 22907 Lyden Dr, Estero, FL 33928 | 2016-09-22 |
| 1275982654 | Eileen Cherbini | Counselor | 13616 Canola Ct, Estero, FL 33928 | 2016-06-07 |
| 1952759342 | Alexander Conrad | Counselor | 8010 Sardinia Way Unit #221, Estero, FL 33928 | 2016-05-26 |
| 1154700466 | Estero Eyecare | Clinic/Center | 21753 Brixham Run Loop, Estero, FL 33928 | 2015-05-20 |
| 1982082335 | Gulfshore Pediatric Dentistry, P.a. | Dentist | 9921 Corkscrew Rd, Estero, FL 33928 | 2015-05-18 |
| 1942697149 | Conor William Byrt | Emergency Medicine | 21731 Sound Way, 102, Estero, FL 33928 | 2015-04-25 |
| 1063728616 | Eye Doctors Optical Outlets | Optometrist | 23101 South Tamiami Trail, Suite 440, Estero, FL 33928 | 2010-08-20 |
| Find all providers in zip 33928 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497938963 | Richard R. Wilson, D.o. | General Practice | 10201 Arcos Ave Suite 202, Estero, FL 33928 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
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| 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.