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

Kimora Maxwell

Individual provider Physical Therapy Assistant · NPI 1497508071

Kimora Maxwell is a Physical Therapy Assistant in Saint Augustine, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2024

Practice location Address checks out

1690 US Highway 1 S Ste F
Saint Augustine, FL 32084-6024
Phone: (904) 634-0640
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA33169 (FL)

Record details

NPI number1497508071
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 11, 2024
Last updated in NPPESApril 11, 2024
Certification dateApril 11, 2024
Mailing address1690 Us Highway 1 S Ste F, Saint Augustine, FL 32084-6024

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