Individual
KIMBERLY MCILWAIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13801 BRUCE B DOWNS BLVD STE 406, TAMPA, FL 33613
(813) 345-2380
(813) 971-5247
Mailing address
13801 BRUCE B DOWNS BLVD STE 406, TAMPA, FL 33613-3923
(813) 345-2380
(813) 971-5247
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME86595
FL
207RR0500X
Rheumatology Physician
Primary
ME86595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0248708
CIGNA
FL
01
—
06400
UNIVERSAL
FL
01
—
1100764
BAYCARE
FL
01
—
29413
BLUE CROSS BLUE SHIELD
FL
01
—
592041688H
HUMANA
FL
01
—
P00298799
RAILROAD MEDICARE
FL
Enumeration date
08/31/2006
Last updated
01/17/2019
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