Individual
KIBIBI DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
7532 CLEARVIEW DR, TAMPA, FL 33634
(813) 525-6135
Mailing address
7532 CLEARVIEW DR, TAMPA, FL 33634-2930
(813) 525-6135
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO4035
FL
213E00000X
Podiatrist
SC006042
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016.005441
IL
213EP1101X
Primary Podiatric Medicine Podiatrist
07001101A
IN
390200000X
Student in an Organized Health Care Education/Training Program
SC006042
PA
Other
Enumeration date
07/14/2008
Last updated
03/11/2019
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