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Individual

BIMOTA NAMBAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-3636
(727) 767-3638
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-4881

Taxonomy

Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
2025-02042
NC
2080P0205X
Pediatric Endocrinology Physician
MD207600
LA
2080P0205X
Pediatric Endocrinology Physician
Primary
ME143220
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2390813
LA
Enumeration date
08/31/2009
Last updated
08/08/2025
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