Individual
KIMBERLY N THIVIERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 396-5682
(904) 346-0864
Mailing address
820 PRUDENTIAL DR, SUITE 713, JACKSONVILLE, FL 32207-8210
(904) 396-5682
(904) 346-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME112636
FL
Other
Enumeration date
05/25/2010
Last updated
09/20/2013
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