Individual
KIMBERLY PRINCESS RADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
37944 CHURCH AVE, DADE CITY, FL 33525
(352) 518-2000
(352) 567-5193
Mailing address
PO BOX 232, DADE CITY, FL 33526
(352) 518-2000
(352) 567-5193
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1059411
FL
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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