Individual
MRS. KIMBERLY ANN JEROME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1485 LEGENDS BLVD, CHAMPIONS GATE, FL 33896-8393
(407) 390-6480
(407) 390-6483
Mailing address
6106 HUCKLEBERRY AVE, ORLANDO, FL 32819-4176
(407) 668-5431
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106227
FL
Other
Enumeration date
12/10/2011
Last updated
09/26/2019
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