Kirby, Pamela

Kirby, Pamela is an sole proprietor health care provider with primary practice located at 4606 S Clyde Morris Blvd Ste 1J, Port Orange FL 32129-7453. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as her primary health care specialty. Kirby, Pamela can be contacted via phone (386) 788-4111.

Contact Information

Primary practice address
4606 S Clyde Morris Blvd Ste 1J Port Orange FL 32129-7453
Phone: (386) 788-4111
Fax: (386) 788-4113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 593418264 Florida

Profile Details

NPI number 1518960780
LBN Legal business name Kirby, Pamela
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2005
Last updated Sep 13th, 2012 - about 12 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 1518960780 NPPES
Florida Other 593418264 TAX ID
Florida MEDICAID 390329000 TAX ID

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