Individual provider Active NPI

Kimberley A Ghuman, M.D.

  • Pediatrics Physician
  • Cape Coral, FL
National Provider Identifier
1306833280
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0081195 Issued in FL
Practice address
650 Del Prado Blvd S Ste 107
Cape Coral, FL 33990
Phone
(239) 343-9888
Fax
(239) 424-4091
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0081195 FL Primary

Addresses

Primary practice location

650 Del Prado Blvd S Ste 107
Cape Coral, FL 33990

Mailing address

PO Box 2147
Ft Myers, FL 33902-2147
Phone (239) 343-9888

Other practice location 1

4751 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9888

Other identifiers 1

IdentifierTypeStateIssuer
259788800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110317000733 FL Practitioner - Pediatric Medicine 1557544285 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0081195FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc Pediatrics CurrentSince Oct 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

650 Del Prado Blvd S
Ste 107
Cape Coral, FL 33990

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

4751 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9880

8960 Colonial Center Dr
Ste 302
Fort Myers, FL 33905
Phone (239) 343-9633

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1306833280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9888",
            "fax_number": "239-424-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 DEL PRADO BLVD S STE 107",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33990",
            "telephone_number": "239-343-9888",
            "fax_number": "239-424-4091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4751 S Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339071317",
            "country_code": "US",
            "telephone_number": "239-343-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHUMAN",
        "first_name": "KIMBERLEY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0081195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259788800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.