Individual
MRS. KIMBERLY ANNE IFILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1309 N. FLASLER DR., WEST PALM BEACH, FL 33401
(786) 218-0963
(561) 253-9175
Mailing address
110 S K ST #3, LAKE WORTH BEACH, FL 33460
(786) 218-0963
(561) 253-9175
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102435
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9102435
LICENSE
FL
Enumeration date
05/11/2006
Last updated
07/29/2024
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