| Kielle Medical Limited Liability Company | |
|
5988 Duckweed Rd Lake Worth FL 33449-5810 | |
| (561) 767-0903 | |
| Not Available |
| Full Name | Kielle Medical Limited Liability Company |
|---|---|
| Speciality | Internal Medicine |
| Location | 5988 Duckweed Rd, Lake Worth, Florida |
| Authorized Official Name and Position | Kitonga Kiminyo (EMPLOYEE) |
| Authorized Official Contact | 5617670903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kielle Medical Limited Liability Company 5988 Duckweed Rd Lake Worth FL 33449-5810 Ph: (561) 767-0903 | Kielle Medical Limited Liability Company 5988 Duckweed Rd Lake Worth FL 33449-5810 Ph: (561) 767-0903 |
| NPI Number | 1366076515 |
|---|---|
| Provider Enumeration Date | 02/26/2020 |
| Last Update Date | 02/26/2020 |
| Medicare PECOS PAC ID | 2062832744 |
|---|---|
| Medicare Enrollment ID | O20201019001901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366076515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Kitonga P Kiminyo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649373101 PECOS PAC ID: 8325945322 Enrollment ID: I20120131000176 |
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