Individual
DR. KIM FULLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5665 PONCE DE LEON BLVD, ROOM 213, CORAL GABLES, FL 33146-2510
(305) 284-6874
(305) 284-1700
Mailing address
5665 PONCE DE LEON BLVD, ROOM 213, CORAL GABLES, FL 33146-2510
(305) 284-6874
(305) 284-1700
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY4602
FL
103TC0700X
Clinical Psychologist
PY4602
FL
Other
Enumeration date
10/12/2005
Last updated
09/11/2025
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