Individual
DR. PAUL B KORNBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2914 N BOULEVARD, TAMPA, FL 33602-1208
(813) 228-7696
(813) 228-0677
Mailing address
2914 N BOULEVARD, TAMPA, FL 33602-1208
(813) 228-7696
(813) 228-0677
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
ME0085060
FL
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
ME0085060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13779
BLUE CROSS
FL
05
—
2641542-00
—
FL
01
—
2850138
AETNA
FL
01
—
716175
CIGNA
FL
01
—
N216229
WELLCARE (NON-PAR)
FL
Enumeration date
04/21/2006
Last updated
10/28/2011
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