Individual
KIMBERLY A LOVELACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3637 CORTEZ RD W, STE 103, BRADENTON, FL 34210-3106
(941) 739-7828
(941) 739-7838
Mailing address
3637 CORTEZ RD W, STE 103, BRADENTON, FL 34210-3106
(941) 739-7828
(941) 739-7838
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT9042
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2288818
AETNA
FL
01
—
DA6508
RR MCR PROVIDER
FL
01
—
P00066542
RR MCR PROVIDER
FL
01
—
Y909J
BCBS PROVDER
FL
Enumeration date
10/14/2005
Last updated
10/11/2007
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