MEDICARE: KIMBERLY A. GIFFARD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	225865	NY
2	208600000X	Surgery Physician	ME101901	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487673687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY A. GIFFARD M.D.

Provider Business Mailing Address
First Line	:	266 S MOON AVE
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-5711
Country	:	US
Telephone Number	:	813-655-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	4051 UPPER CREEK DR STE 108
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-6825
Country	:	US
Telephone Number	:	813-634-9264
Fax Number	:	813-634-8578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/25/2019

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Directions to “ KIMBERLY A. GIFFARD M.D.” Practice Location

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