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Individual

DR. CHARLES HUMPHREY KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-1115
(352) 273-8610
Mailing address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 843-5851
(321) 843-1673

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
D0045080
MD
207L00000X
Anesthesiology Physician
Primary
ME132190
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107975600
FL
05
310010300
MD
05
ME132190
FL
01
P00654786
RAILROAD MEDICARE
MD
Enumeration date
01/22/2007
Last updated
07/03/2024
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