Basic Information
| Provider Information | |||||||||
| NPI: | 1730576695 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOHAR | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | NGUYEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2724 N HIAWASSEE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328183008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079060082 | ||||||||
| FaxNumber: | 4076042606 | ||||||||
| Practice Location | |||||||||
| Address1: | 2724 N HIAWASSEE RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328183008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079060082 | ||||||||
| FaxNumber: | 4076042606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2015 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS15893 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.