Individual
KIMBERLY MICHELLE BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 SW ARCHER ROAD, GAINESVILLE, FL 32610-3001
(352) 265-0291
Mailing address
1711 LAKE WAUMPI DR, WINTER PARK, FL 32789-0905
(405) 413-7574
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
297339
NY
2085R0202X
Diagnostic Radiology Physician
Primary
ME128578
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107828500
—
FL
01
—
S6029
MEDICARE HF
FL
Enumeration date
06/19/2015
Last updated
01/05/2026
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