Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kin Med, PA

Organization General Practice Physician · NPI 1861994204

Kin Med, PA is a General Practice Physician in Estero, Florida. Licensed in Florida. Registered with an NPI since 2018.

Licensed in
FL
In the registry since
2018
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

19910 S Tamiami Trl Ste C
Estero, FL 33928
Phone: (239) 948-1222
Fax: (239) 948-1221
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence CH11313 (FL)
General Practice Physician Taxonomy 208D00000X · Licence CH11148
Physician Assistant Taxonomy 363A00000X · Licence P.A.9104809 (FL)

Record details

NPI number1861994204
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lyette Boucher — President · (239) 948-1222
NPI enumeratedMarch 1, 2018
Last updated in NPPESMarch 1, 2018
Mailing address19910 S. Tamiami Trail Ste C, Estero, FL 33928

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