Evans, Kimberley Dorene

Evans, Kimberley Dorene is an individual health care provider with primary practice located at 1227 S Myrtle Ave , Clearwater FL 33756-3469. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Evans, Kimberley Dorene can be contacted via phone (727) 939-6196.

Contact Information

Primary practice address
1227 S Myrtle Ave Clearwater FL 33756-3469
Phone: (727) 939-6196
Fax: (727) 350-9396
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X ME0085477 Florida

Profile Details

NPI number 1396840500
LBN Legal business name Evans, Kimberley Dorene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Jun 22nd, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396840500 NPPES
Florida Other P00932367 MEDICARE RAILROAD PROVIDER NUMBER
Florida MEDICAID 265776700 MEDICARE RAILROAD PROVIDER NUMBER

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