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Individual

KIMBERLY FRYER SEGRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
101 AVENUE O SE, WINTER HAVEN, FL 33880-4333
(863) 294-7010
Mailing address
8503 MAGNOLIA ST, GIBSONTON, FL 33534-4501
(864) 608-4099

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
LL34895
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
ME136489
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
025057400
FL
01
I9VKE
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/15/2012
Last updated
07/14/2025
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