1548978661 NPI number — KIMBERLY MCDOUGALL ARNP, FNP-C

Table of content: KONSTANTIN G. ZAHAROFF JR. MD (NPI 1932271780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548978661 NPI number — KIMBERLY MCDOUGALL ARNP, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCDOUGALL
Provider First Name:
KIMBERLY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548978661
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6101 BLUE LAGOON DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33126-3168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-533-6836
Provider Business Mailing Address Fax Number:
407-770-0661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18414 US HIGHWAY 281 N STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78259-7611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-495-0222
Provider Business Practice Location Address Fax Number:
855-494-6035
Provider Enumeration Date:
11/08/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1098363 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)