Active NPI
Min Jee Kim, PHARMD
- Pharmacist
- Fort Myers, FL
National Provider Identifier
1336833979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS64218
- Practice address
- 13681 Doctors Way
Fort Myers, FL 33912-4300 - Phone
- (239) 343-1000
- NPI assigned
- Jun 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS64218 | FL | Primary |
Addresses
Primary practice location
13681 Doctors Way
Fort Myers, FL 33912-4300
Mailing address
119 Palisade LN
Shreveport, LA 71115-3248
Phone (318) 230-3104
Other practice location 1
703 N Flamingo Rd
Pembroke Pines, FL 33028-1014
Phone (954) 436-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS64218 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1336833979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 PALISADE LN",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711153248",
"telephone_number": "318-230-3104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13681 DOCTORS WAY",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124300",
"telephone_number": "239-343-1000"
}
],
"practiceLocations": [
{
"address_1": "703 N Flamingo Rd",
"address_purpose": "LOCATION",
"city": "Pembroke Pines",
"state": "FL",
"postal_code": "330281014",
"country_code": "US",
"telephone_number": "954-436-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "MIN",
"middle_name": "JEE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-06",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS64218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.