Individual
DR. KIMBERLY NICOLE GOSS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2502 W SAINT ISABEL ST, SUITE B, TAMPA, FL 33607-6370
(813) 874-5707
Mailing address
2502 W SAINT ISABEL ST, SUITE B, TAMPA, FL 33607-6370
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME119165
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2012
Last updated
12/19/2015
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