KIN MED, PA
NPI 1861994204
General Practice in Estero, FL

Q: What is Kin Med, PA's NPI number?

The NPI number for Kin Med, PA is 1861994204. It was assigned to this organization in the NPPES registry on March 1, 2018.

Q: What is Kin Med, PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Kin Med, PA was last updated on March 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 March 01, 2018

19910 S TAMIAMI TRAIL STE C, ESTERO, FL 33928(239) 948-1222(239) 948-1221 Get Directions Write a Review

NPPES record last updated: March 1, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kin Med, Pa NPPES

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

KIN MED, PA (NPI 1861994204) is a healthcare organization registered as a general practice in Estero, Florida and active in the NPI registry since March 2018. The organization lists Lyette Rose Boucher, President, as its authorized official.

NPPES Registry Identity

NPI1861994204

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameKIN MED, PA

Location Address19910 S TAMIAMI TRAIL STE CEstero, FL 33928

Mailing Address19910 S. Tamiami Trail Ste CEstero, FL 33928 · (239) 948-1222 · Fax (239) 948-1221

Phone(239) 948-1222

Fax(239) 948-1221

Organization SubpartNo

Authorized OfficialLyette Rose BoucherPresident · (239) 948-1222

Enumeration DateMarch 1, 2018

✔ NPI 1861994204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Licenses✔ Licensed in FL · CH11313✔ Licensed · CH11148

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedPhysician AssistantTaxonomy 363A00000X · License P.A.9104809 (FL)

19910 S TAMIAMI TRAIL STE C, Estero, FL 33928

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kin Med, PA's NPI number?

The NPI number for Kin Med, PA is 1861994204. It was assigned to this organization in the NPPES registry on March 1, 2018.

Where is Kin Med, PA located?

Kin Med, PA is located at 19910 S Tamiami Trail Ste C, Estero, FL 33928. The listed phone number is (239) 948-1222.

What is Kin Med, PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Kin Med, PA was last updated on March 1, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.