Individual
KIMBERLI FANUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4701 SW COLLEGE RD STE 107, OCALA, FL 34474-4739
(352) 291-0728
Mailing address
4240 SW 58TH AVE, OCALA, FL 34474-9538
(352) 342-7768
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CL1176537
FL
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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