person
Kimberly Ann Vonderlieth, PA
Surgical Physician Assistant in Melbourne, Florida
NPI 1396917522

Kimberly Ann Vonderlieth is a Surgical Physician Assistant based in Rockledge, FL and is specialized in Surgical. Kimberly Ann Vonderlieth practices in Melbourne, FL and has the professional credentials of PA. The NPI Number for Kimberly Ann Vonderlieth is 1396917522 and holds a License No. PA9101648 (Florida).

The current practice location address for Kimberly Ann Vonderlieth is 1350 Hickory St, Melbourne, FL and can be reached out via phone at 321-434-1401 and via fax at 321-434-1667.

Location: 1350 Hickory St, Melbourne, FL, 32955-4306
person
Provider Profile Details
NPI Number
1396917522
Provider Name
Kimberly Ann Vonderlieth
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
1350 Hickory St, Melbourne, FL, 32955-4306
Phone Number
321-434-1401
Fax Number
321-434-1667
Provider Enumeration Date
03/27/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LS853 01 FL FL MEDICARE
104257000 05 FL
LY388 01 FL FL MEDICARE
institution
Provider Business Practice Location Address Details
Address
1350 Hickory St
City
State
Zip
32901-3224
Phone Number
321-434-1401
Fax Number
321-434-1667
person
Provider Business Mailing Address Details
Address
1350 Hickory St
City
State
Zip
32901-3224
Phone Number
321-434-1401
Fax Number
321-434-1667
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA9101648 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA9101648 (Florida)
Definition
Definition to come...
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