Kimberly Marino-Micheel, DOM,LAc,AP,Dipl,RN
Integrative Medicine in Englewood, FL. Individual provider (NPI-1).
NPI number1124989686
StatusActive
Last updated in NPPESNov 22, 2025
Details
- NPI
- 1124989686
- Entity type
- Individual (NPI-1)
- Name
- Kimberly Marino-Micheel
- Credential
- DOM,LAc,AP,Dipl,RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 22, 2025
- Certification date
- Nov 22, 2025
- Last updated
- Nov 22, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 202D00000X | Integrative Medicine | L.Ac4693 | FL | Yes |
Practice location
630 N Indiana AveEnglewood, FL 34223-2728
Phone 941-812-0777
Mailing address
1970 Forked Creek DrEnglewood, FL 34223-1710
Phone 941-812-0777
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 10 free a day, then credits from $29 for 5,000. Useful for credentialing, billing and pharmacy claim checks.