KIMBERLY REGENESIS – NPI #1811342397
Clinic/Center

KIMBERLY REGENESIS is an AHC clinic located in FORT MYERS, FL. NPPES has assigned the NPI number 1811342397 to KIMBERLY REGENESIS on May 03, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QR0405X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rehabilitation, Substance Use Disorder

The NPI profile was previously updated about 10 years ago on Jul 21, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KIMBERLY REGENESIS below.

NPI Profile for
KIMBERLY REGENESIS

NPI Number
1811342397
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KIMBERLY REGENESIS
Primary location
8695 COLLEGE PARKWAY
SUITE 2080
FORT MYERS, FL 33919
Phone: (239) 313-0296 Fax:
Mailing address
14661 DOUBLE EAGLE COURT
FT MYERS, FL 33912
Phone: (239) 313-0296 Fax: (239) 939-1070
Organization Subpart
No
Authorized Official
THOMAS MOURACADE
PRINCIPAL/OWNER
Phone: (239) 313-0296
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR0405X
- Clinic/Center / Rehabilitation, Substance Use Disorder (Primary)
324500000X
- Substance Abuse Rehabilitation Facility

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.