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Individual

KATHLEEN ELIZABETH MINNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11551 SOUTHERN BLVD STE 2, ROYAL PALM BEACH, FL 33411-4254
(561) 594-1850
(561) 594-1855
Mailing address
PO BOX 20800, BELFAST, ME 04915-4105
(561) 270-5505
(561) 437-0177

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME 78137
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1023956
CAREPLUS
FL
01
1092080
WELLCARE
FL
05
256694000
FL
01
259940
AVMED
FL
01
4586865
AETNA
FL
01
46572
BCBS
FL
01
8877
DIMENSION
FL
01
P1035432
FREEDOM
FL
01
P971167
OPTIMUM
FL
Enumeration date
09/20/2005
Last updated
11/11/2025
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