Individual
DR. RANDY SCOTT KIMMELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3467 W HILLSBORO BLVD, SUITE B, DEERFIELD BEACH, FL 33442-9473
(954) 574-0252
(954) 429-1759
Mailing address
3467 W HILLSBORO BLVD, SUITE B, DEERFIELD BEACH, FL 33442-9473
(954) 574-0252
(954) 429-1759
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS7449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
241859
AVMED
FL
05
—
252588700
—
FL
01
—
57516
BCBS OF FLORIDA
FL
01
—
57516U
MEDICARE - FL
FL
Enumeration date
08/15/2006
Last updated
11/17/2020
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