Kenneth Mark Zimmerman, BACHOLER OF PHARMACY

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS0019320 Issued in FL

Practice address

2900 Lakeland Highlands Rd
Lakeland, FL 33803-4379

Phone

(863) 667-2711

Fax

(863) 667-1868

NPI assigned

Feb 25, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093841108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 LEIGHTON AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032520",
            "telephone_number": "863-682-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LAKELAND HIGHLANDS RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034379",
            "telephone_number": "863-667-2711",
            "fax_number": "863-667-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "KENNETH",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "BACHOLER OF PHARMACY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0019320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103999700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Paul Zetty, D.O.
• Andre Zibner, PHARM.D.
• Erin Zimmer
• James F Zimmer, MD
• Karen Zimmerman, LMHC
• Laura Zimmerman, APRN
• Elizabeth A Ziner, DO
• Lovemore Zinhema, APRN
• Carol Zoffinger, LMHC; CAP
• Samantha Zorn, MA, LMHC

• Pharmacist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.