Healthcare Provider Details

I. General information

NPI: 1669462677
Provider Name (Legal Business Name): KIMBERLY LAWUS SCURRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20360 GATOR LN BLDG 14
LAND O LAKES FL
34638-2802
US

IV. Provider business mailing address

20360 GATOR LN BLDG 14
LAND O LAKES FL
34638-2802
US

V. Phone/Fax

Practice location:
  • Phone: 813-346-3400
  • Fax: 813-346-3491
Mailing address:
  • Phone: 813-346-3400
  • Fax: 813-346-3491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME79025
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP3753
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: