KIM MARA DIERICKX PA
NPI 1518424951
Physician Assistant - Medical in North Miami Beach, FL

Q: What is Kim Dierickx's NPI number?

The NPI number for Kim Dierickx is 1518424951. It was assigned to this individual provider in the NPPES registry on February 21, 2019.

Q: What is Kim Dierickx's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kim Dierickx was last updated on February 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 21, 2019

100 NW 170TH ST STE 301, NORTH MIAMI BEACH, FL 33169(305) 651-3038(305) 655-1153 Get Directions Write a Review

NPPES record last updated: February 21, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kim Mara Dierickx Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM MARA DIERICKX PA (NPI 1518424951) is an individual medical provider in North Miami Beach, Florida, licensed in Florida (9111531) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1518424951

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKIM MARA DIERICKXCredential: PA

Location Address100 NW 170TH ST STE 301North Miami Beach, FL 33169-5511

Mailing Address100 Nw 170th St Ste 301North Miami Beach, FL 33169-5511 · (305) 651-3038 · Fax (305) 655-1153

Phone(305) 651-3038

Fax(305) 655-1153

Sole ProprietorYes

Enumeration DateFebruary 21, 2019

✔ NPI 1518424951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in FL · 9111531

100 NW 170TH ST STE 301, North Miami Beach, FL 33169

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTINA RAJIC PA-C

Physician Assistant (Medical)