Individual
MRS. ALYSSA DANIELLE KIMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME149322
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115353200
—
FL
01
—
KX1X2
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/02/2019
Last updated
09/13/2022
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