Individual
DR. KIMBERLEY DORENE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1227 S MYRTLE AVE, CLEARWATER, FL 33756-3469
(727) 939-6196
(727) 350-9396
Mailing address
1227 S MYRTLE AVE, CLEARWATER, FL 33756-3469
(727) 939-6196
(727) 350-9396
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME0085477
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265776700
—
FL
01
—
P00932367
MEDICARE RAILROAD PROVIDER NUMBER
FL
Enumeration date
09/13/2006
Last updated
06/22/2014
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