Individual
KIP C CULLIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8381 RIVERWALK PARK BLVD, SUITE 101, FORT MYERS, FL 33919-8760
(239) 936-5425
(239) 936-5176
Mailing address
8381 RIVERWALK PARK BLVD, SUITE 101, FORT MYERS, FL 33919-8760
(239) 936-5425
(239) 936-5176
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME0071841
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070009505
RR MEDICARE
FL
01
—
32504
BC BS OF FLA
FL
01
—
5361863002
CIGNA
FL
01
—
5762385
AETNA
FL
Enumeration date
03/31/2006
Last updated
12/26/2013
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