Kimberly Marino-Micheel, DOM,LAC,AP,DIPL,RN

Primary specialty

Integrative Medicine PhysicianTaxonomy code 202D00000X

License

L.AC4693 Issued in FL

Practice address

630 N Indiana Ave
Englewood, FL 34223-2728

Phone

(941) 812-0777

NPI assigned

Nov 22, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1763769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1124989686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 FORKED CREEK DR",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342231710",
            "telephone_number": "941-812-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342232728",
            "telephone_number": "941-812-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO-MICHEEL",
        "first_name": "KIMBERLY",
        "credential": "DOM,LAC,AP,DIPL,RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-22",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Integrative Medicine",
            "state": "FL",
            "license": "L.AC4693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Grace Pepper Lynch, PA-C
• Lynn R Bernstein & Associates PA
• Mac Innovation
• Tayler Brianne Madison
• Margaret a. Gainey M.D.
• Mark Konwiser MD PA
• Jacquelyn Nikol Martinez
• Scott T Martz, DO
• Alvin Mathew, PT
• Holly Michelle Maxfield, APRN

• Integrative Medicine Physician in Englewood, FL
• Providers in Englewood, FL by specialty
• Integrative Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2025; 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.