Burgnon, Kimberly
Burgnon, Kimberly is an sole proprietor health care provider with primary practice located at 561 E Mitchell Hammock Rd Ste 200 , Oviedo FL 32765-5526. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Burgnon, Kimberly can be contacted via phone (407) 810-7674.Contact Information
Primary practice address
561 E Mitchell Hammock Rd Ste 200
Oviedo FL 32765-5526
Phone: (407) 810-7674
Fax: (321) 348-0118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH9095 | Florida |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | IMH 4726 | Florida |
Profile Details
| NPI number | 1518006089 |
|---|---|
| LBN Legal business name | Burgnon, Kimberly |
| Credentials | Master of Education (MED) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Aug 8th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518006089 | NPPES |
| Florida | MEDICAID | 762539100 |
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