Individual
DR. MELINDA L LACERNA-KIMBRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5301 4TH AVENUE CIR E, BRADENTON, FL 34208-5623
(941) 954-4500
Mailing address
219 N. 18TH ST W, BRADENTON, FL 34205
(805) 607-8342
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME109505
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
A72404
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A724040
—
CA
Enumeration date
01/08/2007
Last updated
07/13/2021
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