Individual ProviderKimberly DaleNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5540 E Grant St Ste A, Orlando, FL 32822-1668(407) 367-4706PECOS EnrollmentBased on the most recent information from CMS, provider Kimberly Dale is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1427583046Provider TypeIndividualFull NameDale, KimberlyTitleMs.CredentialAPRNGenderFemaleSole ProprietorNoEnumeration Date4/21/2017Last Updated5/20/2020Contact InformationPractice LocationPractice Address5540 E Grant St Ste A, Orlando, FL 32822-1668Phone(407) 367-4706Fax(321) 203-4606Mailing LocationMailing Address5540 E Grant St Ste A, Orlando, FL 32822-1668Phone(407) 367-4706Fax(321) 203-4606Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseARNP 9235978Florida