Individual provider Active NPI

Kimber Vasquez, MD

  • General Practice Physician
  • Avon Park, FL
National Provider Identifier
1689803330
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN293 Issued in FL
Practice address
950 County Road 17a W
Avon Park, FL 33825-2164
Phone
(863) 452-3000
Fax
(863) 452-3077
NPI assigned
Jul 2, 2009
Last updated
Jul 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN293 FL Primary

Addresses

Primary practice location

950 County Road 17a W
Avon Park, FL 33825-2164

Mailing address

950 County Road 17a W
Avon Park, FL 33825-2164
Phone (863) 452-3000

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246492800000",
    "number": "1689803330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 COUNTY ROAD 17A W",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252164",
            "telephone_number": "863-452-3000",
            "fax_number": "863-452-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 COUNTY ROAD 17A W",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252164",
            "telephone_number": "863-452-3000",
            "fax_number": "863-452-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "KIMBER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.