Individual
EILEEN E KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5117 FIORELLA LN, SANFORD, FL 32771-5449
(407) 489-0800
Mailing address
5117 FIORELLA LN, SANFORD, FL 32771-5449
(407) 489-0800
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
PA9111629
FL
363A00000X
Physician Assistant
PA9111629
FL
Other
Enumeration date
10/25/2018
Last updated
04/06/2020
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