Individual
ERINMARIE O KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01091391A
IN
207R00000X
Internal Medicine Physician
ME136172
FL
207RH0003X
Hematology & Oncology Physician
01091391A
IN
207RH0003X
Hematology & Oncology Physician
Primary
ME136172
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103157703
ANTHEM PTAN
IN
05
—
300082453
—
IN
Enumeration date
04/20/2016
Last updated
03/12/2025
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